Boston Scientific Applied Biomedical Engineering Professor, Shriram Chair of Bioengineering, and Professor of Bioengineering and of Radiology and, by courtesy, of Electrical Engineering

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Bio

Norbert Pelc is chair of the Department of Bioengineering. His primary research interests are in the physics, engineering, and mathematics of diagnostic imaging and the development of applications of this imaging technology. His current work focuses on computed tomography, specifically in methods to improve the information content and image quality and to reduce the radiation dose from these examinations. He holds doctorate and master degrees in Medical Radiological Physics from Harvard University and a BS from the University of Wisconsin in Madison. He served on the first National Advisory Council of the National Institute of Biomedical Imaging and Bioengineering of the NIH. He is a member of the National Academy of Engineering and a Fellow of the American Association of Physicists in Medicine, the International Society for Magnetic Resonance in Medicine, and the American Institute of Medical and Biological Engineering.

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Current Research and Scholarly Interests

Medical imaging has made enormous strides in recent decades. In clinical medicine, imaging plays an increasingly important role in patient care. A recent study found that internists rank the development of computed tomography (CT) and magnetic resonance imaging (MRI), together, as the most important innovation in medicine (Health Affairs, Vol 20, p. 30, 2001). At the same time, experts in a completely different scientific field, the National Academy of Engineering, ranks the development of imaging as one of the top 20 greatest engineering achievements of the 20th century (www.greatachievements.org), amazingly at a rank higher than that of household appliances and nuclear technology. Imaging is also taking on an increasing role in research, improving our understanding of both normal and diseased states and as a surrogate endpoint in the evaluation of therapies. Imaging allows serial studies in the same individual, thereby increasing statistical power and reducing the number of subjects needed in a study. Imaging is also a powerful tool to guide minimally invasive therapies.

The effectiveness of imaging and the powerful impact of visual images have led to a major increase in the utilization of this strategy, a trend that will continue but will evolve in coming years. Further advances will lead to improved detection, localization, and characterization of disease which should enable more accurate selection of optimized therapies for individual subjects (personalized medicine) as well as treatments that are more effective, less expensive, and less traumatic. Imaging will also play an increasingly important role in the challenges facing biomedical research.

There are many imaging “modalities”, each acquiring data using physical mechanisms such as x-ray transmission, nuclear magnetic resonance, acoustic or optical properties, and signals from radioactive tracers. Optimal design and utilization of each requires an appreciation of the underlying physical phenomena. Each modality uses sensors to detect signals and mathematical methods to covert the measured signals to images. Additional image processing methods are used to extract physiological information from the images.

My own interests center on the physics, engineering and mathematics of medical imaging. While I have worked on many imaging modalities over the past decades, my current projects are focused on computed tomography, digital x-ray imaging, and hybrid multimodality systems. One major project currently underway is the development of Inverse Geometry Computed Tomography (IGCT), a new CT imaging architecture that should allow volumetric imaging with outstanding image quality and lower radiation dose. The work involves research into new components, sampling strategies, and image reconstruction methods, as well as methods to characterize the performance of imaging systems. We are also interested in energy-dependent CT imaging for tissue characterization and improved efficiency.

Currently, image guided therapy is typically performed using real-time guidance from a single modality, most commonly x-ray fluoroscopy. I believe that many procedures would benefit if the physician, during the procedure, could choose from a number of imaging technologies (e.g., x-ray fluoroscopy, MRI, PET) and with minimal impact on the patient. I am interested in the development of “hybrid” platforms that would provide such access. Development of such platforms requires careful attention to allow each modality to provide its unique type of information while not interfering with the other systems.

In addition to these technical projects, I am also interested in the development of new clinical and research applications of medical imaging. This is highly interdisciplinary research, incorporating not only the latest imaging technology but also fundamental appreciation of anatomy and pathophysiology.

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Abstract

Multi-detector computed tomography (MDCT) enables volumetric scans in a single breath hold and is clinically useful for hepatic imaging. For simple tasks, conventional single energy (SE) computed tomography (CT) images acquired at the optimal tube potential are known to have better quality than dual energy (DE) blended images. However, liver imaging is complex and often requires imaging of both structures containing iodinated contrast media, where atomic number differences are the primary contrast mechanism, and other structures, where density differences are the primary contrast mechanism. Hence it is conceivable that the broad spectrum used in a dual energy acquisition may be an advantage. In this work we are interested in comparing these two imaging strategies at equal-dose and more complex settings.We developed numerical anthropomorphic phantoms to mimic realistic clinical CT scans for medium size and large size patients. MDCT images based on the defined phantoms were simulated using various SE and DE protocols at pre- and post-contrast stages. For SE CT, images from 60 kVp through 140 with 10 kVp steps were considered; for DE CT, both 80/140 and 100/140 kVp scans were simulated and linearly blended at the optimal weights. To make a fair comparison, the mAs of each scan was adjusted to match the reference radiation dose (120 kVp, 200 mAs for medium size patients and 140 kVp, 400 mAs for large size patients). Contrast-to-noise ratio (CNR) of liver against other soft tissues was used to evaluate and compare the SE and DE protocols, and multiple pre- and post-contrasted liver-tissue pairs were used to define a composite CNR. To help validate the simulation results, we conducted a small clinical study. Eighty-five 120 kVp images and 81 blended 80/140 kVp images were collected and compared through both quantitative image quality analysis and an observer study.In the simulation study, we found that the CNR of pre-contrast SE image mostly increased with increasing kVp while for post-contrast imaging 90 kVp or lower yielded higher CNR images, depending on the differential iodine concentration of each tissue. Similar trends were seen in DE blended CNR and those from SE protocols. In the presence of differential iodine concentration (i.e., post-contrast), the CNR curves maximize at lower kVps (80-120), with the peak shifted rightward for larger patients. The combined pre- and post-contrast composite CNR study demonstrated that an optimal SE protocol has better performance than blended DE images, and the optimal tube potential for SE scan is around 90 kVp for a medium size patients and between 90 and 120 kVp for large size patients (although low kVp imaging requires high x-ray tube power to avoid photon starvation). Also, a tin filter added to the high kVp beam is not only beneficial for material decomposition but it improves the CNR of the DE blended images as well. The dose adjusted CNR of the clinical images also showed the same trend and radiologists favored the SE scans over blended DE images.Our simulation showed that an optimized SE protocol produces up to 5% higher CNR for a range of clinical tasks. The clinical study also suggested 120 kVp SE scans have better image quality than blended DE images. Hence, blended DE images do not have a fundamental CNR advantage over optimized SE images.

Abstract

This paper presents an overview of multisource inverse-geometry computed tomography (IGCT) as well as the development of a gantry-based research prototype system. The development of the distributed x-ray source is covered in a companion paper [V. B. Neculaes et al., "Multisource inverse-geometry CT. Part II. X-ray source design and prototype," Med. Phys. 43, 4617-4627 (2016)]. While progress updates of this development have been presented at conferences and in journal papers, this paper is the first comprehensive overview of the multisource inverse-geometry CT concept and prototype. The authors also provide a review of all previous IGCT related publications.The authors designed and implemented a gantry-based 32-source IGCT scanner with 22 cm field-of-view, 16 cm z-coverage, 1 s rotation time, 1.09 × 1.024 mm detector cell size, as low as 0.4 × 0.8 mm focal spot size and 80-140 kVp x-ray source voltage. The system is built using commercially available CT components and a custom made distributed x-ray source. The authors developed dedicated controls, calibrations, and reconstruction algorithms and evaluated the system performance using phantoms and small animals.The authors performed IGCT system experiments and demonstrated tube current up to 125 mA with up to 32 focal spots. The authors measured a spatial resolution of 13 lp/cm at 5% cutoff. The scatter-to-primary ratio is estimated 62% for a 32 cm water phantom at 140 kVp. The authors scanned several phantoms and small animals. The initial images have relatively high noise due to the low x-ray flux levels but minimal artifacts.IGCT has unique benefits in terms of dose-efficiency and cone-beam artifacts, but comes with challenges in terms of scattered radiation and x-ray flux limits. To the authors' knowledge, their prototype is the first gantry-based IGCT scanner. The authors summarized the design and implementation of the scanner and the authors presented results with phantoms and small animals.

Abstract

This paper summarizes the development of a high-power distributed x-ray source, or "multisource," designed for inverse-geometry computed tomography (CT) applications [see B. De Man et al., "Multisource inverse-geometry CT. Part I. System concept and development," Med. Phys. 43, 4607-4616 (2016)]. The paper presents the evolution of the source architecture, component design (anode, emitter, beam optics, control electronics, high voltage insulator), and experimental validation.Dispenser cathode emitters were chosen as electron sources. A modular design was adopted, with eight electron emitters (two rows of four emitters) per module, wherein tungsten targets were brazed onto copper anode blocks-one anode block per module. A specialized ceramic connector provided high voltage standoff capability and cooling oil flow to the anode. A matrix topology and low-noise electronic controls provided switching of the emitters.Four modules (32 x-ray sources in two rows of 16) have been successfully integrated into a single vacuum vessel and operated on an inverse-geometry computed tomography system. Dispenser cathodes provided high beam current (>1000 mA) in pulse mode, and the electrostatic lenses focused the current beam to a small optical focal spot size (0.5 × 1.4 mm). Controlled emitter grid voltage allowed the beam current to be varied for each source, providing the ability to modulate beam current across the fan of the x-ray beam, denoted as a virtual bowtie filter. The custom designed controls achieved x-ray source switching in <1 ?s. The cathode-grounded source was operated successfully up to 120 kV.A high-power, distributed x-ray source for inverse-geometry CT applications was successfully designed, fabricated, and operated. Future embodiments may increase the number of spots and utilize fast read out detectors to increase the x-ray flux magnitude further, while still staying within the stationary target inherent thermal limitations.

Abstract

Energy-discriminating, photon-counting (EDPC) detectors are attractive for their potential for improved detective quantum efficiency and for their spectral imaging capabilities. However, at high count rates, counts are lost, the detected spectrum is distorted, and the advantages of EDPC detectors disappear. Existing EDPC detectors identify counts by analyzing the signal with a bank of comparators. We explored alternative methods for pulse detection for multibin EDPC detectors that could improve performance at high count rates. The detector signal was simulated in a Monte Carlo fashion assuming a bipolar shape and analyzed using several methods, including the conventional bank of comparators. For example, one method recorded the peak energy of the pulse along with the width (temporal extent) of the pulse. The Cramer-Rao lower bound of the variance of basis material estimates was numerically found for each method. At high count rates, the variance in water material (bone canceled) measurements could be reduced by as much as an order of magnitude. Improvements in virtual monoenergetic images were modest. We conclude that stochastic noise in spectral imaging tasks could be reduced if alternative methods for pulse detection were utilized.

Abstract

To find an upper bound on the maximum dose reduction possible for any reconstruction algorithm, analytic or iterative, that result from the inclusion of the data statistics. The authors do not analyze noise reduction possible from prior knowledge or assumptions about the object.The authors examined the task of estimating the density of a circular lesion in a cross section. Raw data were simulated by forward projection of existing images and numerical phantoms. To assess an upper bound on the achievable dose reduction by any algorithm, the authors assume that both the background and the shape of the lesion are completely known. Under these conditions, the best possible estimate of the density can be determined by solving a weighted least squares problem directly in the raw data domain. Any possible reconstruction algorithm that does not use prior knowledge or make assumptions about the object, including filtered backprojection (FBP) or iterative reconstruction methods with this constraint, must be no better than this least squares solution. The authors simulated 10?000 sets of noisy data and compared the variance in density from the least squares solution with those from FBP. Density was estimated from FBP images using either averaging within a ROI, or streak-adaptive averaging with better noise performance.The bound on the possible dose reduction depends on the degree to which the observer can read through the possibly streaky noise. For the described low contrast detection task with the signal shape and background known exactly, the average dose reduction possible compared to FBP with streak-adaptive averaging was 42% and it was 64% if only the ROI average is used with FBP. The exact amount of dose reduction also depends on the background anatomy, with statistically inhomogeneous backgrounds showing greater benefits.The dose reductions from new, statistical reconstruction methods can be bounded. Larger dose reductions in the density estimation task studied here are only possible with the introduction of prior knowledge, which can introduce bias.

Abstract

A multi-source inverse-geometry CT (MS-IGCT) system consists of a small 2D detector array and multiple x-ray sources. During data acquisition, each source is activated sequentially, and may have random source intensity fluctuations relative to their respective nominal intensity. While a conventional 3rd generation CT system uses a reference channel to monitor the source intensity fluctuation, the MS-IGCT system source illuminates a small portion of the entire field-of-view (FOV). Therefore, it is difficult for all sources to illuminate the reference channel and the projection data computed by standard normalization using flat field data of each source contains error and can cause significant artifacts. In this work, we present a raw data normalization algorithm to reduce the image artifacts caused by source intensity fluctuation. The proposed method was tested using computer simulations with a uniform water phantom and a Shepp-Logan phantom, and experimental data of an ice-filled PMMA phantom and a rabbit. The effect on image resolution and robustness of the noise were tested using MTF and standard deviation of the reconstructed noise image. With the intensity fluctuation and no correction, reconstructed images from simulation and experimental data show high frequency artifacts and ring artifacts which are removed effectively using the proposed method. It is also observed that the proposed method does not degrade the image resolution and is very robust to the presence of noise.

Abstract

Energy-discriminating, photon counting (EDPC) detectors have high potential in spectral imaging applications but exhibit degraded performance when the incident count rate approaches or exceeds the characteristic count rate of the detector. In order to reduce the requirements on the detector, we explore the strategy of modulating the X-ray flux field using a recently proposed dynamic, piecewise-linear attenuator. A previous paper studied this modulation for photon counting detectors but did not explore the impact on spectral applications. In this work, we modeled detection with a bipolar triangular pulse shape (Taguchi et al., 2011) and estimated the Cramer-Rao lower bound (CRLB) of the variance of material selective and equivalent monoenergetic images, assuming deterministic errors at high flux could be corrected. We compared different materials for the dynamic attenuator and found that rare earth elements, such as erbium, outperformed previously proposed materials such as iron in spectral imaging. The redistribution of flux reduces the variance or dose, consistent with previous studies on benefits with conventional detectors. Numerical simulations based on DICOM datasets were used to assess the impact of the dynamic attenuator for detectors with several different characteristic count rates. The dynamic attenuator reduced the peak incident count rate by a factor of 4 in the thorax and 44 in the pelvis, and a 10 Mcps/mm (2) EDPC detector with dynamic attenuator provided generally superior image quality to a 100 Mcps/mm (2) detector with reference bowtie filter for the same dose. The improvement is more pronounced in the material images.

Abstract

Truncation artifacts in CT occur if the object to be imaged extends past the scanner field of view (SFOV). These artifacts impede diagnosis and could possibly introduce errors in dose plans for radiation therapy. Several approaches exist for correcting truncation artifacts, but existing correction algorithms do not accurately recover the skin line (or support) of the patient, which is important in some dose planning methods. The purpose of this paper was to develop an iterative algorithm that recovers the support of the object.The authors assume that the truncated portion of the image is made up of soft tissue of uniform CT number and attempt to find a shape consistent with the measured data. Each known measurement in the sinogram is interpreted as an estimate of missing mass along a line. An initial estimate of the object support is generated by thresholding a reconstruction made using a previous truncation artifact correction algorithm (e.g., water cylinder extrapolation). This object support is iteratively deformed to reduce the inconsistency with the measured data. The missing data are estimated using this object support to complete the dataset. The method was tested on simulated and experimentally truncated CT data.The proposed algorithm produces a better defined skin line than water cylinder extrapolation. On the experimental data, the RMS error of the skin line is reduced by about 60%. For moderately truncated images, some soft tissue contrast is retained near the SFOV. As the extent of truncation increases, the soft tissue contrast outside the SFOV becomes unusable although the skin line remains clearly defined, and in reformatted images it varies smoothly from slice to slice as expected.The support recovery algorithm provides a more accurate estimate of the patient outline than thresholded, basic water cylinder extrapolation, and may be preferred in some radiation therapy applications.

Abstract

Photon counting x-ray detectors (PCXDs) offer several advantages compared to standard energy-integrating x-ray detectors, but also face significant challenges. One key challenge is the high count rates required in CT. At high count rates, PCXDs exhibit count rate loss and show reduced detective quantum efficiency in signal-rich (or high flux) measurements. In order to reduce count rate requirements, a dynamic beam-shaping filter can be used to redistribute flux incident on the patient. We study the piecewise-linear attenuator in conjunction with PCXDs without energy discrimination capabilities. We examined three detector models: the classic nonparalyzable and paralyzable detector models, and a 'hybrid' detector model which is a weighted average of the two which approximates an existing, real detector (Taguchi et al 2011 Med. Phys. 38 1089-102 ). We derive analytic expressions for the variance of the CT measurements for these detectors. These expressions are used with raw data estimated from DICOM image files of an abdomen and a thorax to estimate variance in reconstructed images for both the dynamic attenuator and a static beam-shaping ('bowtie') filter. By redistributing flux, the dynamic attenuator reduces dose by 40% without increasing peak variance for the ideal detector. For non-ideal PCXDs, the impact of count rate loss is also reduced. The nonparalyzable detector shows little impact from count rate loss, but with the paralyzable model, count rate loss leads to noise streaks that can be controlled with the dynamic attenuator. With the hybrid model, the characteristic count rates required before noise streaks dominate the reconstruction are reduced by a factor of 2 to 3. We conclude that the piecewise-linear attenuator can reduce the count rate requirements of the PCXD in addition to improving dose efficiency. The magnitude of this reduction depends on the detector, with paralyzable detectors showing much greater benefit than nonparalyzable detectors.

Abstract

The authors describe algorithms to control dynamic attenuators in CT and compare their performance using simulated scans. Dynamic attenuators are prepatient beam shaping filters that modulate the distribution of x-ray fluence incident on the patient on a view-by-view basis. These attenuators can reduce dose while improving key image quality metrics such as peak or mean variance. In each view, the attenuator presents several degrees of freedom which may be individually adjusted. The total number of degrees of freedom across all views is very large, making many optimization techniques impractical. The authors develop a theory for optimally controlling these attenuators. Special attention is paid to a theoretically perfect attenuator which controls the fluence for each ray individually, but the authors also investigate and compare three other, practical attenuator designs which have been previously proposed: the piecewise-linear attenuator, the translating attenuator, and the double wedge attenuator.The authors pose and solve the optimization problems of minimizing the mean and peak variance subject to a fixed dose limit. For a perfect attenuator and mean variance minimization, this problem can be solved in simple, closed form. For other attenuator designs, the problem can be decomposed into separate problems for each view to greatly reduce the computational complexity. Peak variance minimization can be approximately solved using iterated, weighted mean variance (WMV) minimization. Also, the authors develop heuristics for the perfect and piecewise-linear attenuators which do not require a priori knowledge of the patient anatomy. The authors compare these control algorithms on different types of dynamic attenuators using simulated raw data from forward projected DICOM files of a thorax and an abdomen.The translating and double wedge attenuators reduce dose by an average of 30% relative to current techniques (bowtie filter with tube current modulation) without increasing peak variance. The 15-element piecewise-linear dynamic attenuator reduces dose by an average of 42%, and the perfect attenuator reduces dose by an average of 50%. Improvements in peak variance are several times larger than improvements in mean variance. Heuristic control eliminates the need for a prescan. For the piecewise-linear attenuator, the cost of heuristic control is an increase in dose of 9%. The proposed iterated WMV minimization produces results that are within a few percent of the true solution.Dynamic attenuators show potential for significant dose reduction. A wide class of dynamic attenuators can be accurately controlled using the described methods.

Abstract

We present initial experimental results of a rotating-gantry multi-source inverse-geometry CT (MS-IGCT) system. The MS-IGCT system was built with a single module of 2 × 4 x-ray sources and a 2D detector array. It produced a 75 mm in-plane field-of-view (FOV) with 160 mm axial coverage in a single gantry rotation. To evaluate system performance, a 2.5 inch diameter uniform PMMA cylinder phantom, a 200 µm diameter tungsten wire, and a euthanized rat were scanned. Each scan acquired 125 views per source and the gantry rotation time was 1 s per revolution. Geometric calibration was performed using a bead phantom. The scanning parameters were 80 kVp, 125 mA, and 5.4 µs pulse per source location per view. A data normalization technique was applied to the acquired projection data, and beam hardening and spectral nonlinearities of each detector channel were corrected. For image reconstruction, the projection data of each source row were rebinned into a full cone beam data set, and the FDK algorithm was used. The reconstructed volumes from upper and lower source rows shared an overlap volume which was combined in image space. The images of the uniform PMMA cylinder phantom showed good uniformity and no apparent artifacts. The measured in-plane MTF showed 13 lp cm(-1) at 10% cutoff, in good agreement with expectations. The rat data were also reconstructed reliably. The initial experimental results from this rotating-gantry MS-IGCT system demonstrated its ability to image a complex anatomical object without any significant image artifacts and to achieve high image resolution and large axial coverage in a single gantry rotation.

Abstract

Dose efficiency of dual kVp imaging can be improved if the two beams are filtered to remove photons in the common part of their spectra, thereby increasing spectral separation. While there are a number of advantages to rapid kVp-switching for dual energy, it may not be feasible to have two different filters for the two spectra. Therefore, the authors are interested in whether a fixed added filter can improve the dose efficiency of kVp-switching dual energy x-ray systems.The authors hypothesized that a K-edge filter would provide the energy selectivity needed to remove overlap of the spectra and hence increase the precision of material separation at constant dose. Preliminary simulations were done using calcium and water basis materials and 80 and 140 kVp x-ray spectra. Precision of the decomposition was evaluated based on the propagation of the Poisson noise through the decomposition function. Considering availability and cost, the authors chose a commercial Gd2O2S screen as the filter for their experimental validation. Experiments were conducted on a table-top system using a phantom with various thicknesses of acrylic and copper and 70 and 125 kVp x-ray spectra. The authors kept the phantom exposure roughly constant with and without filtration by adjusting the tube current. The filtered and unfiltered raw data of both low and high energy were decomposed into basis material and the variance of the decomposition for each thickness pair was calculated. To evaluate the filtration performance, the authors measured the ratio of material decomposition variance with and without filtration.Simulation results show that the ideal filter material depends on the object composition and thickness, and ranges across the lanthanide series, with higher atomic number filters being preferred for more attenuating objects. Variance reduction increases with filter thickness, and substantial reductions (40%) can be achieved with a 2× loss in intensity. The authors' experimental results validate the simulations, yet were overall slightly worse than expectation. For large objects, conventional (non-K-edge) beam hardening filters perform well.This study demonstrates the potential of fixed K-edge filtration to improve the dose efficiency and material decomposition precision for rapid kVp-switching dual energy systems.

Abstract

The authors recently proposed a dynamic, prepatient x-ray attenuator capable of producing a piecewise-linear attenuation profile customized to each patient and viewing angle. This attenuator was intended to reduce scatter-to-primary ratio (SPR), dynamic range, and dose by redistributing flux. In this work the authors tested the ability of the attenuator to reduce dose and SPR in simulations.The authors selected four clinical applications, including routine full field-of-view scans of the thorax and abdomen, and targeted reconstruction tasks for an abdominal aortic aneurysm and the pancreas. Raw data were estimated by forward projection of the image volume datasets. The dynamic attenuator was controlled to reduce dose while maintaining peak variance by solving a convex optimization problem, assuminga priori knowledge of the patient anatomy. In targeted reconstruction tasks, the noise in specific regions was given increased weighting. A system with a standard attenuator (or "bowtie filter") was used as a reference, and used either convex optimized tube current modulation (TCM) or a standard TCM heuristic. The noise of the scan was determined analytically while the dose was estimated using Monte Carlo simulations. Scatter was also estimated using Monte Carlo simulations. The sensitivity of the dynamic attenuator to patient centering was also examined by shifting the abdomen in 2 cm intervals.Compared to a reference system with optimized TCM, use of the dynamic attenuator reduced dose by about 30% in routine scans and 50% in targeted scans. Compared to the TCM heuristics which are typically used withouta priori knowledge, the dose reduction is about 50% for routine scans. The dynamic attenuator gives the ability to redistribute noise and variance and produces more uniform noise profiles than systems with a conventional bowtie filter. The SPR was also modestly reduced by 10% in the thorax and 24% in the abdomen. Imaging with the dynamic attenuator was relatively insensitive to patient centering, showing a 17% increase in peak variance for a 6 cm shift of the abdomen, instead of an 82% increase in peak variance for a fixed bowtie filter.A dynamic prepatient x-ray attenuator consisting of multiple wedges is capable of achieving substantial dose reductions and modest SPR reductions.

Abstract

Computed tomography (CT) has made enormous technical advances since its introduction into clinical use. The engineering improvements have in turn led to important clinical applications and large impact in patient care. This paper reviews the technology development trends in CT since its introduction and uses these trends to help illuminate likely future progress. The prediction is that significant further improvements in speed, spatial resolution and dose efficiency can be expected in the next decade.

To bin or not to bin? The effect of CT system limiting resolution on noise and detectabilityPHYSICS IN MEDICINE AND BIOLOGYBaek, J., Pineda, A. R., Pelc, N. J.2013; 58 (5): 1433-1446

Abstract

We examine the noise advantages of having a computed tomography (CT) detector whose spatial resolution is significantly better (e.g. a factor of 2) than needed for a desired resolution in the reconstructed images. The effective resolution of detectors in x-ray CT is sometimes degraded by binning cells because the small cell size and fine sampling are not needed to achieve the desired resolution (e.g. with flat panel detectors). We studied the effect of the binning process on the noise in the reconstructed images and found that while the images in the absence of noise can be made identical for the native and the binned system, for the same system MTF in the presence of noise, the binned system always results in noisier reconstructed images. The effect of the increased noise in the reconstructed images on lesion detection is scale (frequency content) dependent with a larger difference between the high resolution and binned systems for imaging fine structure (small objects). We show simulated images reconstructed with both systems for representative objects and quantify the impact of the noise on the detection of the lesions based on mathematical observers. Through both subjective assessment of the reconstructed images and the quantification using mathematical observers, we show that for a CT system where the photon noise is dominant, higher resolution in the detectors leads to better noise performance in the reconstructed images at any resolution.

Abstract

Inverse geometry computed tomography (IGCT) has been proposed as a new system architecture that combines a small detector with a large, distributed source. This geometry can suppress cone-beam artifacts, reduce scatter, and increase dose efficiency. However, the temporal resolution of IGCT is still limited by the gantry rotation time. Large reductions in rotation time are in turn difficult due to the large source array and associated power electronics. We examine the feasibility of using stationary source arrays for IGCT in order to achieve better temporal resolution. We anticipate that multiple source arrays are necessary, with each source array physically separated from adjacent ones.Key feasibility issues include spatial resolution, artifacts, flux, noise, collimation, and system timing clashes. The separation between the different source arrays leads to missing views, complicating reconstruction. For the special case of three source arrays, a two-stage reconstruction algorithm is used to estimate the missing views. Collimation is achieved using a rotating collimator with a small number of holes. A set of equally spaced source spots are designated on the source arrays, and a source spot is energized when a collimator hole is aligned with it. System timing clashes occur when multiple source spots are scheduled to be energized simultaneously. We examine flux considerations to evaluate whether sufficient flux is available for clinical applications.The two-stage reconstruction algorithm suppresses cone-beam artifacts while maintaining resolution and noise characteristics comparable to standard third generation systems. The residual artifacts are much smaller in magnitude than the cone-beam artifacts eliminated. A mathematical condition is given relating collimator hole locations and the number of virtual source spots for which system timing clashes are avoided. With optimization, sufficient flux may be achieved for many clinical applications.IGCT with stationary source arrays could be an imaging platform potentially capable of imaging a complete 16-cm thick volume within a tenth of a second.

Abstract

The prepatient attenuator (or "bowtie filter") in CT is used to modulate the flux as a function of fan angle of the x-ray beam incident on the patient. Traditional, static bowtie filters are tailored only for very generic scans and for the average patient. The authors propose a design for a dynamic bowtie that can produce a time-dependent piecewise-linear attenuation profile. This dynamic bowtie may reduce dynamic range, dose or scatter, but in this work they focus on its ability to reduce dynamic range, which may be particularly important for systems employing photon-counting detectors.The dynamic bowtie is composed of a set of triangular wedges. Each wedge is independently moved in order to produce a time-dependent piecewise-linear attenuation profile. Simulations of the bowtie are conducted to estimate the dynamic range reduction in six clinical datasets. The control of the dynamic bowtie is determined by solving a convex optimization problem, and the dose is estimated using Monte Carlo techniques. Beam hardening artifacts are also simulated.The dynamic range is reduced by factors ranging from 2.4 to 27 depending on the part of the body studied. With a dynamic range minimization objective, the dose to the patient can be reduced from 6% to 33% while maintaining peak image noise. Further reduction in dose may be possible with a specific dose reduction objective. Beam hardening artifacts are suppressed with a two-pass algorithm.A dynamic bowtie producing a time-dependent, piecewise-linear attenuation profile is possible and can be used to modulate the flux of the scanner to the imaging task. Initial simulations show a large reduction in dynamic range. Several other applications are possible.

Abstract

Using hybrid x-ray?MR (XMR) systems for image guidance during interventional procedures could enhance the diagnosis and treatment of neurologic, oncologic, cardiovascular, and other disorders. The authors propose a close proximity hybrid system design in which a C-arm fluoroscopy unit is placed immediately adjacent to the solenoid magnet of a MR system with a minimum distance of 1.2 m between the x-ray and MR imaging fields of view. Existing rotating anode x-ray tube designs fail within MR fringe field environments because the magnetic fields alter the electron trajectories in the x-ray tube and act as a brake on the induction motor, reducing the rotation speed of the anode. In this study the authors propose a novel motor design that avoids the anode rotation speed reduction.The proposed design replaces the permanent magnet stator found in brushed dc motors with the radial component of the MR fringe field. The x-ray tube is oriented such that the radial component of the MR fringe field is orthogonal to the cathode-anode axis. Using a feedback position sensor and the support bearings as electrical slip rings, the authors use electrical commutation to eliminate the need for mechanical brushes and commutators. A vacuum compatible prototype of the proposed motor design was assembled, and its performance was evaluated at various operating conditions. The prototype consisted of a 3.1 in. diameter anode rated at 300 kHU with a ceramic rotor that was 5.6 in. in length and had a 2.9 in. diameter. The material chosen for all ceramic components was MACOR, a machineable glass ceramic developed by Corning Inc. The approximate weight of the entire assembly was 1750 g. The maximum rotation speed, angular acceleration, and acceleration time of the motor design were investigated, as well as the dependence of these parameters on rotor angular offset, magnetic field strength, and field orientation. The resonance properties of the authors' assembly were also evaluated to determine its stability during acceleration, and a pulse width modulation algorithm was implemented to control the rotation speed of the motor.At a magnetic flux density of 41 mT orthogonal to the axis of rotation (on the lower end of the expected flux density in the MR suite) the maximum speed of the motor was found to be 5150 revolutions per minute (rpm). The acceleration time necessary to reach 3000 rpm was found to be approximately 10 s at 59 mT. The resonance frequency of the assembly with the anode attached was 1310 rpm (21.8 Hz) which is far below the desired operating speeds. Pulse width modulation provides an effective method to control the speed of the motor with a resolution of 100 rpm.The proposed design can serve as a direct replacement to the conventional induction motor used in rotating anode x-ray tubes. It does not suffer from a reduced rotation speed when operating in a MR environment. The presence of chromic steel bearings in the prototype prevented testing at the higher field strengths, and future iterations of the design could eliminate this shortcoming. The prototype assembly demonstrates proof of concept of the authors' design and overcomes one of the major obstacles for a MR compatible rotating anode x-ray tube.

Abstract

A bowtie is a filter used to shape an x-ray beam and equalize its flux reaching different detector channels. For development of spectral CT with energy discriminating photon-counting (EDPC) detectors, here we propose and evaluate a dynamic bowtie for performance optimization based on a patient model or a scout scan. With a mechanical rotation of a dynamic bowtie and an adaptive adjustment of an x-ray source flux, an x-ray beam intensity profile can be modulated. First, a mathematical model for dynamic bowtie filtering is established for an elliptical section in fan-beam geometry, and the contour of the optimal bowtie is derived. Then, numerical simulation is performed to compare the performance of the dynamic bowtie in the cases of an ideal phantom and a realistic cross-section relative to the counterparts without any bowtie and with a fixed bowtie respectively. Our dynamic bowtie can equalize the expected numbers of photons in the case of an ideal phantom. In practical cases, our dynamic bowtie can effectively reduce the dynamic range of detected signals inside the field of view. Although our design is optimized for an elliptical phantom, the resultant dynamic bowtie can be applied to a real fan-beam scan if the underlying cross-section can be approximated as an ellipse. Furthermore, our design methodology can be applied to specify an optimized dynamic bowtie for any cross-section of a patient, preferably using rapid prototyping technology.

Abstract

The choice of CT protocol can greatly impact patient dose and image quality. Since acquiring multiple scans at different techniques on a given patient is undesirable, the ability to predict image quality changes starting from a high quality exam can be quite useful. While existing methods allow one to generate simulated images of lower exposure (mAs) from an acquired CT exam, the authors present and validate a new method called synthetic CT that can generate realistic images of a patient at arbitrary low dose protocols (kVp, mAs, and filtration) for both single and dual energy scans.The synthetic CT algorithm is derived by carefully ensuring that the expected signal and noise are accurate for the simulated protocol. The method relies on the observation that the material decomposition from a dual energy CT scan allows the transmission of an arbitrary spectrum to be predicted. It requires an initial dual energy scan of the patient to either synthesize raw projections of a single energy scan or synthesize the material decompositions of a dual energy scan. The initial dual energy scan contributes inherent noise to the synthesized projections that must be accounted for before adding more noise to simulate low dose protocols. Therefore, synthetic CT is subject to the constraint that the synthesized data have noise greater than the inherent noise. The authors experimentally validated the synthetic CT algorithm across a range of protocols using a dual energy scan of an acrylic phantom with solutions of different iodine concentrations. An initial 80/140 kVp dual energy scan of the phantom provided the material decomposition necessary to synthesize images at 100 kVp and at 120 kVp, across a range of mAs values. They compared these synthesized single energy scans of the phantom to actual scans at the same protocols. Furthermore, material decompositions of a 100/120 kVp dual energy scan are synthesized by adding correlated noise to the initial material decompositions. The aforementioned noise constraint also allows us to compute feasible mAs values that can be synthesized for each kVp.The single energy synthesized and actual reconstructed images exhibit identical signal and noise properties at 100 kVp and at 120 kVp, and across a range of mAs values. For example, the noise in both the synthesized and actual images at 100 kVp increases by 2 when the mAs is halved. The synthesized and actual material decompositions of a dual energy protocol show excellent agreement when the decomposition images are linearly weighted to form monoenergetic images at energies from 40 to 100 keV. For simulated single energy protocols with kVp between 80 and 140, the highest feasible mAs exceeds that of either initial scan.This work describes and validates the synthetic CT theory and algorithm by comparing its results to actual scans. Synthetic CT is a powerful new tool that allows users to realistically see how protocol selection affects CT images and enables radiologists to retrospectively identify the lowest dose protocol achievable that provides diagnostic quality images on real patients.

Abstract

The authors examined the effect of detector lag on the noise power spectrum (NPS) of CT images reconstructed with filtered backprojection (FBP).The authors derived an analytical expression of the NPS with detector lag, and then verified it using computer simulations with parallel beam and fan beam geometries. The dependence of the NPS on the amount of lag, location within the scanned field of view (FOV), and the number of views used in the reconstruction (samples per rotation) was investigated using constant and view dependent noise in the raw data.Detector lag introduces noise correlation in the azimuthal direction. The effect on the NPS is a frequency dependent reduction in amplitude. In small regions of the image, the effect is primarily in the frequencies corresponding to the azimuthal direction. The noise blurring and NPS filtering increases with increasing radial distance, and therefore regions at larger radial distances have lower noise power. With the same detector lag response function, the amount of noise correlation and NPS filtering decreases with increasing number of views.The shape of the NPS depends on the detector lag coefficients, location of the region, and the number of views used in the reconstruction. In general, the noise correlation caused by detector lag decreased the amplitude of the NPS.

Abstract

The authors examine the nonstationary noise behavior of a cone-beam CT system with FDK reconstruction.To investigate the nonstationary noise behavior, an analytical expression for the NPS of local volumes and an entire volume was derived and quantitatively compared to the NPS estimated from experimental air and water images.The NPS of local volumes at different locations along the z-axis showed radial symmetry in the f(x)-f(y) plane and different missing cone regions in the f(z) direction depending on the tilt angle of rays through the local volumes. For local volumes away from the z-axis, the NPS of air and water images showed sharp transitions in the f(x)-f(y) and f(y)-f(z) planes and lack of radial symmetry in the f(x)-f(y) plane. These effects are mainly caused by varying magnification and different noise levels from view to view. In the NPS of the entire volume, the f(x)-f(y) plane showed radial symmetry because the nonstationary noise behaviors of local volumes were averaged out. The nonstationary sharp transitions were manifested as a high-frequency roll-off.The results from noise power analysis for local volumes and an entire volume demonstrate the spatially varying noise behavior in the reconstructed cone-beam CT images.

Abstract

It is well known that the energy dependence of X-ray attenuation can be used to characterize materials. Yet, even with energy discriminating photon counting X-ray detectors, it is still unclear how to best form energy dependent measurements for spectral imaging. Common ideas include binning photon counts based on their energies and detectors with both photon counting and energy integrating electronics. These approaches can be generalized to energy weighted measurements, which we prove can form a sufficient statistic for spectral X-ray imaging if the weights used, which we term ?-weights, are basis attenuation functions that can also be used for material decomposition. To study the performance of these different methods, we evaluate the Cramér-Rao lower bound (CRLB) of material estimates in the presence of quantum noise. We found that the choice of binning and weighting schemes can greatly affect the performance of material decomposition. Even with optimized thresholds, binning condenses information but incurs penalties to decomposition precision and is not robust to changes in the source spectrum or object size, although this can be mitigated by adding more bins or removing photons of certain energies from the spectrum. On the other hand, because ?-weighted measurements form a sufficient statistic for spectral imaging, the CRLB of the material decomposition estimates is identical to the quantum noise limited performance of a system with complete energy information of all photons. Finally, we show that ?-weights lead to increased conspicuity over other methods in a simulated calcium contrast experiment.

Abstract

This article presents a new reconstruction method for 3D imaging using a multiple 360 degrees circular orbit cone beam CT system, specifically a way to combine 3D volumes reconstructed with each orbit. The main goal is to improve the noise performance in the combined image while avoiding cone beam artifacts.The cone beam projection data of each orbit are reconstructed using the FDK algorithm. When at least a portion of the total volume can be reconstructed by more than one source, the proposed combination method combines these overlap regions using weighted averaging in frequency space. The local exactness and the noise performance of the combination method were tested with computer simulations of a Defrise phantom, a FORBILD head phantom, and uniform noise in the raw data.A noiseless simulation showed that the local exactness of the reconstructed volume from the source with the smallest tilt angle was preserved in the combined image. A noise simulation demonstrated that the combination method improved the noise performance compared to a single orbit reconstruction.In CT systems which have overlap volumes that can be reconstructed with data from more than one orbit and in which the spatial frequency content of each reconstruction can be calculated, the proposed method offers improved noise performance while keeping the local exactness of data from the source with the smallest tilt angle.

Abstract

Hemodynamics is thought to play a very important role in the initiation, growth, and rupture of intracranial aneurysms. The purpose of our study was to perform in vivo hemodynamic analysis of unruptured intracranial aneurysms of magnetic resonance fluid dynamics using time-resolved three-dimensional phase-contrast MRI (4D-Flow) at 1.5 T and to analyze relationships between hemodynamics and wall shear stress (WSS) and oscillatory shear index (OSI).This study included nine subjects with 14 unruptured aneurysms. 4D-Flow was performed by a 1.5-T magnetic resonance scanner with a head coil. We calculated in vivo streamlines, WSS, and OSI of intracranial aneurysms based on 4D-Flow with our software. We evaluated the number of spiral flows in the aneurysms and compared the differences in WSS or OSI between the vessel and aneurysm and between whole aneurysm and the apex of the spiral flow.3D streamlines, WSS, and OSI distribution maps in arbitrary direction during the cardiac phase were obtained for all intracranial aneurysms. Twelve aneurysms had one spiral flow each, and two aneurysms had two spiral flows each. The WSS was lower and the OSI was higher in the aneurysm compared to the vessel. The apex of the spiral flow had a lower WSS and higher OSI relative to the whole aneurysm.Each intracranial aneurysm in this study had at least one spiral flow. The WSS was lower and OSI was higher at the apex of the spiral flow than the whole aneurysmal wall.

Abstract

Hemodynamics is thought to play a very important role in the initiation, growth, and rupture of intracranial aneurysms. The purpose of our study was to compare hemodynamics of intracranial aneurysms of MR fluid dynamics (MRFD) using 3D cine PC MR imaging (4D-Flow) at 1.5 T and MR-based computational fluid dynamics (CFD).4D-Flow was performed for five intracranial aneurysms by a 1.5 T MR scanner. 3D TOF MR angiography was performed for geometric information. The blood flow in the aneurysms was modeled using CFD simulation based on the finite element method. We used MR angiographic data as the vascular models and MR flow information as boundary conditions in CFD. 3D velocity vector fields, 3D streamlines, shearing velocity maps, wall shear stress (WSS) distribution maps and oscillatory shear index (OSI) distribution maps were obtained by MRFD and CFD and were compared.There was a moderate to high degree of correlation in 3D velocity vector fields and a low to moderate degree of correlation in WSS of aneurysms between MRFD and CFD using regression analysis. The patterns of 3D streamlines were similar between MRFD and CFD. The small and rotating shearing velocities and higher OSI were observed at the top of the spiral flow in the aneurysms. The pattern and location of shearing velocity in MRFD and CFD were similar. The location of high oscillatory shear index obtained by MRFD was near to that obtained by CFD.MRFD and CFD of intracranial aneurysms correlated fairly well.

Abstract

The noise power spectrum (NPS) is a useful metric for understanding the noise content in images. To examine some unique properties of the NPS of fan beam CT, the authors derived an analytical expression for the NPS of fan beam CT and validated it with computer simulations. The nonstationary noise behavior of fan beam CT was examined by analyzing local regions and the entire field-of-view (FOV). This was performed for cases with uniform as well as nonuniform noise across the detector cells and across views. The simulated NPS from the entire FOV and local regions showed good agreement with the analytically derived NPS. The analysis shows that whereas the NPS of a large FOV in parallel beam CT (using a ramp filter) is proportional to frequency, the NPS with direct fan beam FBP reconstruction shows a high frequency roll off. Even in small regions, the fan beam NPS can show a sharp transition (discontinuity) at high frequencies. These effects are due to the variable magnification and therefore are more pronounced as the fan angle increases. For cases with nonuniform noise, the NPS can show the directional dependence and additional effects.

Abstract

P. R. Edholm, R. M. Lewitt, and B. Lindholm, "Novel properties of the Fourier decomposition of the sinogram," in Proceedings of the International Workshop on Physics and Engineering of Computerized Multidimensional Imaging and Processing [Proc. SPIE 671, 8-18 (1986)] described properties of a parallel beam projection sinogram with respect to its radial and angular frequencies. The purpose is to perform a similar derivation to arrive at corresponding properties of a fan-beam projection sinogram for both the equal-angle and equal-spaced detector sampling scenarios.One of the derived properties is an approximately zero-energy region in the two-dimensional Fourier transform of the full fan-beam sinogram. This region is in the form of a double-wedge, similar to the parallel beam case, but different in that it is asymmetric with respect to the frequency axes. The authors characterize this region for a point object and validate the derived properties in both a simulation and a head CT data set. The authors apply these results in an application using algebraic reconstruction.In the equal-angle case, the domain of the zero region is (q,k) for which / k/(k-q) / > R/L, where q and k are the frequency variables associated with the detector and view angular positions, respectively, R is the radial support of the object, and L is the source-to-isocenter distance. A filter was designed to retain only sinogram frequencies corresponding to a specified radial support. The filtered sinogram was used to reconstruct the same radial support of the head CT data. As an example application of this concept, the double-wedge filter was used to computationally improve region of interest iterative reconstruction.Interesting properties of the fan-beam sinogram exist and may be exploited in some applications.

Abstract

The requirements for raw data transmission through a CT scanner slip ring, through the computation system, and for storage of raw CT data can be quite challenging as scanners continue to increase in speed and to collect more data per rotation. Although lossy compression greatly mitigates this problem, users must be cautious about how errors introduced manifest themselves in the reconstructed images. This paper describes two simple yet effective methods for controlling the effect of errors in raw data compression and describe the impact of each stage on the image errors. A CT system simulator (CATSIM, GE Global Research Center, Niskayuna, NY) was used to generate raw CT datasets that simulate different regions of human anatomy. The raw data are digitized by a 20-bit ADC and companded by a log compander. Lossy compression is performed by quantization and is followed by JPEG-LS (lossless), which takes advantage of the correlations between neighboring measurements in the sinogram. Error feedback, a previously proposed method that controls the spatial distribution of reconstructed image errors, and projection filtering, a newly proposed method that takes advantage of the filtered backprojection reconstruction process, are applied independently (and combined) to study their intended impact on the control and behavior of the additional noise due to the compression methods used. The log compander and the projection filtering method considerably reduce image error levels, while error feedback pushes image errors toward the periphery of the field of view. The results for the images are a compression ratio (CR) of 3 that keeps peak compression errors under 1 HU and a CR of 9 that increases image noise by only 1 HU in common CT applications. Lossy compression can substantially reduce raw CT data size at low computational cost. The proposed methods have the flexibility to operate at a wide range of compression ratios and produce predictable, object-independent, and often imperceptible image artifacts.

Abstract

We present a systematic approach for studying positron emission tomography-computed tomography (PET/CT) 3-D virtual fly-through endoscopy and for assessing the accuracy of this technology for visualizing and detecting endobronchial lesions as a function of focal lesion morphology and activity.Capsules designed to simulate endobronchial lesions were filled with activity and introduced into a porcine lung-heart phantom. PET/CT images were acquired, reconstructed, and volume rendered as 3-D fly-through and fly-around visualizations. Anatomical positioning of lesions seen on the 3-D-volume-rendered PET/CT images was compared to the actual position of the capsules.Lesion size was observed to be highly sensitive to PET threshold parameter settings and careful opacity and color transfer function parameter assignment.We have demonstrated a phantom model for studies of PET/CT 3-D virtual fly-through bronchoscopy and have applied this model for understanding the effect of PET thresholding on the visualization and detection of lesions.

Abstract

An inverse-geometry computed tomography (IGCT) system uses a large source array opposite a smaller detector array. A previously described IGCT reconstruction algorithm uses gridding, but this gridding step produces blurring in the reconstructed image. In this article, the authors describe a two-dimensional (2D) IGCT reconstruction algorithm without gridding. In the transverse direction, the raw data of the IGCT system can be viewed as being composed of many fan beams. Because the spacing between source spots is larger than the spot width, each fan beam has undersampled projection data, but the missing samples are effectively provided by other undersampled fan beam views. In the proposed method, a direct fan beam reconstruction algorithm is used to process each undersampled fan beam. Initial images with this method showed ring artifacts caused by nonuniform sampling in the radial direction as compared to an ideal fan beam. A new method for correcting this effect was developed. With this correction, high quality images were obtained. The noise performance of the proposed 2D IGCT reconstruction algorithm was investigated, and it was comparable to that of the fan beam system. A MTF study showed that the proposed method achieves better resolution than the gridding method.

Abstract

Inverse geometry computed tomography (IGCT) is a new type of volumetric CT geometry that employs a large array of x-ray sources opposite a smaller detector array. Volumetric coverage and high isotropic resolution produce very large data sets and therefore require a computationally efficient three-dimensional reconstruction algorithm. The purpose of this work was to adapt and evaluate a fast algorithm based on Defrise's Fourier rebinning (FORE), originally developed for positron emission tomography. The results were compared with the average of FDK reconstructions from each source row. The FORE algorithm is an order of magnitude faster than the FDK-type method for the case of 11 source rows. In the center of the field-of-view both algorithms exhibited the same resolution and noise performance. FORE exhibited some resolution loss (and less noise) in the periphery of the field-of-view. FORE appears to be a fast and reasonably accurate reconstruction method for IGCT.

Abstract

In this x-ray/MR hybrid system an x-ray flat panel detector is placed under the patient cradle, close to the MR volume of interest (VOI), where the magnetic field strength is approximately 0.5 T. Immersed in this strong field, several electronic components inside the detector become magnetized and create an additional magnetic field that is superimposed on the original field of the MR scanner. Even after linear shimming, the field homogeneity of the MR scanner remains disrupted by the detector. The authors characterize the field due to the detector with the field of two magnetic dipoles and further show that two sets of permanent magnets (NdFeB) can withstand the main magnetic field and compensate for the nonlinear components of the additional field. The ideal number of magnets and their locations are calculated based on a field map measured with the detector in place. Experimental results demonstrate great promise for this technique, which may be useful in many settings where devices with magnetic components need to be placed inside or close to an MR scanner.

Abstract

Separation of water from fat tissues in magnetic resonance imaging is important for many applications because signals from fat tissues often interfere with diagnoses that are usually based on water signal characteristics. Water and fat can be separated with images acquired at different echo time shifts. The three-point method solves for the unknown off-resonance frequency together with the water and fat densities. Noise performance of the method, quantified by the effective number of signals averaged (NSA), is an important metric of the water and fat images. The authors use error propagation theory and Monte Carlo simulation to investigate two common reconstructive approaches: an analytic-solution based estimation and a least-squares estimation. Two water-fat chemical shift (CS) encoding strategies, the symmetric (-theta, 0, theta) and the shifted (0, theta, 2theta) schemes are studied and compared. Results show that NSAs of water and fat can be different and they are dependent on the ratio of intensities of the two species and each of the echo time shifts. The NSA is particularly poor for the symmetric (-theta, 0, theta) CS encoding when the water and fat signals are comparable. This anomaly with equal amounts of water and fat is analyzed in a more intuitive geometric illustration. Theoretical prediction of NSA matches well with simulation results at high signal-to-noise ratio (SNR), while deviation arises at low SNR, which suggests that Monte Carlo simulation may be more appropriate to accurately predict noise performance of the algorithm when SNR is low.

Abstract

A hybrid x-ray/MR system combining an x-ray fluoroscopic system and an open-bore magnetic resonance (MR) system offers advantages from both powerful imaging modalities and thus can benefit numerous image-guided interventional procedures. In our hybrid system configurations, the x-ray tube and detector are placed in the MR magnet and therefore experience a strong magnetic field. The electron beam inside the x-ray tube can be deflected by a misaligned magnetic field, which may damage the tube. Understanding the deflection process is crucial to predicting the electron beam deflection and avoiding potential damage to the x-ray tube. For this purpose, the motion of an electron in combined electric (E) and magnetic (B) fields was analyzed theoretically to provide general solutions that can be applied to different geometries. For two specific cases, a slightly misaligned strong field and a perpendicular weak field, computer simulations were performed with a finite-element method program. In addition, experiments were conducted using an open MRI magnet and an inserted electromagnet to quantitatively verify the relationship between the deflections and the field misalignment. In a strong (B > E/c; c: speed of light) and slightly misaligned magnetic field, the deflection in the plane of E and B caused by electrons following the magnetic field lines is the dominant component compared to the deflection in the E X B direction due to the drift of electrons. In a weak magnetic field (B < or = E/c), the main deflection is in the E x B direction and is caused by the perpendicular component of the magnetic field.

Abstract

Current volumetric computed tomography (CT) methods require seconds to acquire a thick volume (>8 cm) with high resolution. Inverse-geometry CT (IGCT) is a new system geometry under investigation that is anticipated to be able to image a thick volume in a single gantry rotation with isotropic resolution and no cone-beam artifacts. IGCT employs a large array of source spots opposite a smaller detector array. The in-plane field of view (FOV) is primarily determined by the size of the source array, in much the same way that the FOV is determined by the size of the detector array in a conventional CT system. Thus, the size of the source array can be a limitation on the achievable FOV. We propose adding additional detector arrays, spaced apart laterally, to increase the in-plane FOV while still using a modestly sized source array. We determine optimal detector placement to maximize the FOV while obtaining relatively uniform sampling. We also demonstrate low wasted radiation of the proposed system through design and simulation of a pre-patient collimator. Reconstructions from simulated projection data show no artifacts when combining the data from the detector arrays. Finally, to demonstrate feasibility of the concept, an anthropomorphic thorax phantom containing a porcine heart was scanned on a prototype table-top system. The reconstructed axial images demonstrate a 45 cm in-plane FOV using a 23 cm source array.

Abstract

To quantify the effect of iodine on the gadolinium (Gd) contrast-enhanced signal in MR arthrography.Saline solutions of Gd contrast agent (0-1 mmol/liter) were mixed with iodinated contrast agent (0-185 mmol/liter). The T1 and T2 relaxation constants of these solutions were measured at 1.5T. Different types of commonly used iodinated contrast agents as well as sodium iodide (NaI) solutions were also analyzed.Iodine caused significant T2 shortening and some T1 shortening in Gd contrast solutions. Both contrast agents independently obeyed the standard relaxation relation, and their mixture obeyed a modified version of this relation. The side chains in various iodine molecules and their viscosities affected the relaxation properties differently. For various spin-echo (SE) sequences, the signal from synovial fluid containing different concentrations of the two contrast agents was calculated. The T2-weighted signal appeared to be most affected by the increase in iodine concentrations. In the absence of Gd contrast, all SE sequences showed an initial increase in signal from iodine contrast.A generalized relation for the relaxivities of Gd contrast in the presence of iodine was established. The side chains of iodine contrast were found to alter the relaxivities of Gd contrast. Imaging with proton density (PD)-weighted SE with only iodine contrast agent was found to be feasible.

Abstract

To visualize the hemodynamics of the intracranial arteries using time-resolved three-dimensional phase-contrast (PC)-MRI (4D-Flow).MR examinations were performed with a 1.5T MR unit on six healthy volunteers (22-50 years old, average = 30 years). 4D-Flow was based on a radiofrequency (RF)-spoiled gradient-echo sequence, and velocity encoding (VENC) was performed along all three spatial directions. Measurements were retrospectively gated to the electrocardiogram (ECG), and cine series of three-dimensional (3D) data sets were generated. The voxel size was 1 x 1 x 1 mm, and acquisition time was 30-40 minutes. 4D data sets were calculated into time-resolved images of 3D streamlines, 3D particle traces, and 2D velocity vector fields by means of flow visualization software.We were able to see the 3D streamlines from the circle of Willis to the bilateral M2 segment of the middle cerebral arteries (MCAs). Time-resolved images of 3D particle traces also clearly demonstrated intracranial arterial flow dynamics. 2D velocity vector fields on the planes traversing the carotid siphon or the basilar tip were clearly visualized. These results were obtained in all six volunteers.4D-Flow helped to elucidate the in vivo 3D hemodynamics of human intracranial arteries. This method may be a useful noninvasive means of analyzing the hemodynamics of intracranial arteries in vivo.

Abstract

When a fixed anode x-ray tube is placed in a magnetic field (B) that is parallel to the anode-cathode axis, the x-ray exposure increases with increasing B. It was hypothesized that the increase was caused by backscattered electrons which were constrained by B and reaccelerated by the electric field onto the x-ray tube target. We performed computer simulations and physical experiments to study the behavior of the backscattered electrons in a magnetic field, and their effects on the radiation output, x-ray spectrum, and off-focal radiation. A Monte Carlo program (EGS4) was used to generate the combined energy and angular distribution of the backscattered electrons. The electron trajectories were traced and their landing locations back on the anode were calculated. Radiation emission from each point was modeled with published data (IPEM Report 78), and thus the exposure rate and x-ray spectrum with the contribution of backscattered electrons could be predicted. The point spread function for a pencil beam of electrons was generated and then convolved with the density map of primary electrons incident on the anode as simulated with a finite element program (Opera-3d, Vector Fields, UK). The total spatial distribution of x-ray emission could then be calculated. Simulations showed that for an x-ray tube working at 65 kV, about 54% of the electrons incident on the target were backscattered. In a magnetic field of 0.5 T, although the exposure would be increased by 33%, only a small fraction of the backscattered electrons landed within the focal spot area. The x-ray spectrum was slightly shifted to lower energies and the half value layer (HVL) was reduced by about 6%. Measurements of the exposure rate, half value layer and focal spot distribution were acquired as functions of B. Good agreement was observed between experimental data and simulation results. The wide spatial distribution of secondary x-ray emission can degrade the MTF of the x-ray system at low spatial frequencies for B < 0.5 T.

Abstract

Allometric scaling laws relate structure or function between species of vastly different sizes. They have rarely been derived for hemodynamic parameters known to affect the cardiovascular system, e.g., wall shear stress (WSS). This work describes noninvasive methods to quantify and determine a scaling law for WSS. Geometry and blood flow velocities in the infrarenal aorta of mice and rats under isoflurane anesthesia were quantified using two-dimensional magnetic resonance angiography and phase-contrast magnetic resonance imaging at 4.7 tesla. Three-dimensional models constructed from anatomic data were discretized and used for computational fluid dynamic simulations using phase-contrast velocity imaging data as inlet boundary conditions. WSS was calculated along the infrarenal aorta and compared between species to formulate an allometric equation for WSS. Mean WSS along the infrarenal aorta was significantly greater in mice and rats compared with humans (87.6, 70.5, and 4.8 dyn/cm(2), P < 0.01), and a scaling exponent of -0.38 (R(2) = 0.92) was determined. Manipulation of the murine genome has made small animal models standard surrogates for better understanding the healthy and diseased human cardiovascular system. It has therefore become increasingly important to understand how results scale from mouse to human. This noninvasive methodology provides the opportunity to serially quantify changes in WSS during disease progression and/or therapeutic intervention.

Abstract

A table-top volumetric CT system has been implemented that is able to image a 5-cm-thick volume in one circular scan with no cone-beam artifacts. The prototype inverse-geometry CT (IGCT) scanner consists of a large-area, scanned x-ray source and a detector array that is smaller in the transverse direction. The IGCT geometry provides sufficient volumetric sampling because the source and detector have the same axial, or slice direction, extent. This paper describes the implementation of the table-top IGCT scanner, which is based on the NexRay Scanning-Beam Digital X-ray system (NexRay, Inc., Los Gatos, CA) and an investigation of the system performance. The alignment and flat-field calibration procedures are described, along with a summary of the reconstruction algorithm. The resolution and noise performance of the prototype IGCT system are studied through experiments and further supported by analytical predictions and simulations. To study the presence of cone-beam artifacts, a "Defrise" phantom was scanned on both the prototype IGCT scanner and a micro CT system with a +/-5 cone angle for a 4.5-cm volume thickness. Images of inner ear specimens are presented and compared to those from clinical CT systems. Results showed that the prototype IGCT system has a 0.25-mm isotropic resolution and that noise comparable to that from a clinical scanner with equivalent spatial resolution is achievable. The measured MTF and noise values agreed reasonably well with theoretical predictions and computer simulations. The IGCT system was able to faithfully reconstruct the laminated pattern of the Defrise phantom while the micro CT system suffered severe cone-beam artifacts for the same object. The inner ear acquisition verified that the IGCT system can image a complex anatomical object, and the resulting images exhibited more high-resolution details than the clinical CT acquisition. Overall, the successful implementation of the prototype system supports the IGCT concept for single-rotation volumetric scanning free from cone-beam artifacts.

Abstract

We performed time-resolved 3D phase-contrast MR imaging by using a 1.5T MR scanner to visualize hemodynamics in a silicon vascular model with a middle cerebral aneurysm. We ran an aqueous solution of glycerol as a flowing fluid with a pulsatile pump. Time-resolved images of 3D streamlines and 2D velocity vector fields clearly demonstrated that the aneurysm had 3D complex vortex flows within it during systolic phase. This technique provided us with time-resolved 3D hemodynamic information about the intracranial aneurysm.

Abstract

Water-fat separation can be challenging in the presence of field inhomogeneities. Three-point (3-pt) water-fat separation methods achieve robust performance by measuring and compensating for field inhomogeneities; however, they triple the scan time. The "1+-pt" water-fat separation method proposed in this article for dynamic or repetitive imaging situations combines 3-pt methods' ability to correct for field inhomogeneities with the scan efficiency of a single acquisition method to achieve high temporal and spatial resolutions and robust water-fat separation. Single-echo data are collected with water and fat at a relative phase shift of an odd multiple of pi/2. To correct for undesired phase modulation, phase maps are estimated from a 3-pt calibration scan acquired prior to dynamic imaging. The phase maps are assumed to be slowly varying in time, so they may be used for correcting the phase of the subsequent single-echo signals at the same imaging location. Noise performance was investigated and shown to be equivalent to a single excitation acquisition. The 1+-pt method can also be used in conjunction with parallel imaging. In this situation, the calibration scans required by both methods can be integrated into a shared calibration scan. Promising results were obtained in breast, abdominal, and cardiac imaging applications.

Abstract

An inverse-geometry volumetric computed tomography (IGCT) system has been proposed capable of rapidly acquiring sufficient data to reconstruct a thick volume in one circular scan. The system uses a large-area scanned source opposite a smaller detector. The source and detector have the same extent in the axial, or slice, direction, thus providing sufficient volumetric sampling and avoiding cone-beam artifacts. This paper describes a reconstruction algorithm for the IGCT system. The algorithm first rebins the acquired data into two-dimensional (2D) parallel-ray projections at multiple tilt and azimuthal angles, followed by a 3D filtered backprojection. The rebinning step is performed by gridding the data onto a Cartesian grid in a 4D projection space. We present a new method for correcting the gridding error caused by the finite and asymmetric sampling in the neighborhood of each output grid point in the projection space. The reconstruction algorithm was implemented and tested on simulated IGCT data. Results show that the gridding correction reduces the gridding errors to below one Hounsfield unit. With this correction, the reconstruction algorithm does not introduce significant artifacts or blurring when compared to images reconstructed from simulated 2D parallel-ray projections. We also present an investigation of the noise behavior of the method which verifies that the proposed reconstruction algorithm utilizes cross-plane rays as efficiently as in-plane rays and can provide noise comparable to an in-plane parallel-ray geometry for the same number of photons. Simulations of a resolution test pattern and the modulation transfer function demonstrate that the IGCT system, using the proposed algorithm, is capable of 0.4 mm isotropic resolution. The successful implementation of the reconstruction algorithm is an important step in establishing feasibility of the IGCT system.

Abstract

Robust fat suppression techniques are required for many clinical applications. Multi-echo water-fat separation methods are relatively insensitive to B(0) field inhomogeneity compared to the fat saturation method. Estimation of this field inhomogeneity, or field map, is an essential and important step, which is well known to have ambiguity. For an iterative water-fat decomposition method recently proposed, ambiguities still exist, but are more complex in nature. They were studied by analytical expressions and simulations. To avoid convergence to incorrect field map solutions, an initial guess closer to the true field map is necessary. This can be achieved using a region growing process, which correlates the estimation among neighboring pixels. Further improvement in stability is achieved using a low-resolution reconstruction to guide the selection of the starting pixels for the region growing. The proposed method was implemented and shown to significantly improve the algorithm's immunity to field inhomogeneity.

Abstract

The aim of this study was to examine the effect of forced diving on cardiac dynamics in a diving mammal by evaluating cardiac output and heart rate. We used MR Imaging and phase contrast flow analysis to obtain accurate flow measurements from the base of the aorta. Heart rate (fh) and cardiac output (Q) were measured before, during and after dives in four restrained juvenile northern elephant seals, Mirounga angustirostris, and stroke volume (Vs) was calculated (Vs=Q/fh). Mean Q during diving (4011+/-387 ml min(-1)) and resting (6530+/-1018 ml min(-1)) was not significantly different (paired t-test; P<0.055). Diving was accompanied by a 20% increase in Vs over the pre-dive level. Pre-dive, post-dive or diving fh was not significantly correlated with Vs during any state. Diving Vs correlated negatively with the bradycardic ratio (diving fh to pre-dive fh). In this study, the degree of bradycardia during diving was less than in previous pinniped studies, suggesting that the reduction in vagal input may contribute to the observed increase in Vs.

Abstract

Chemical shift based methods are often used to achieve uniform water-fat separation that is insensitive to Bo inhomogeneities. Many spin-echo (SE) or fast SE (FSE) approaches acquire three echoes shifted symmetrically about the SE, creating time-dependent phase shifts caused by water-fat chemical shift. This work demonstrates that symmetrically acquired echoes cause artifacts that degrade image quality. According to theory, the noise performance of any water-fat separation method is dependent on the proportion of water and fat within a voxel, and the position of echoes relative to the SE. To address this problem, we propose a method termed "iterative decomposition of water and fat with echo asymmetric and least-squares estimation" (IDEAL). This technique combines asymmetrically acquired echoes with an iterative least-squares decomposition algorithm to maximize noise performance. Theoretical calculations predict that the optimal echo combination occurs when the relative phase of the echoes is separated by 2pi/3, with the middle echo centered at pi/2+pik (k=any integer), i.e., (-pi/6+pik, pi/2+pik, 7pi/6+pik). Only with these echo combinations can noise performance reach the maximum possible and be independent of the proportion of water and fat. Close agreement between theoretical and experimental results obtained from an oil-water phantom was observed, demonstrating that the iterative least-squares decomposition method is an efficient estimator.

Abstract

We have installed an improved X-ray/MR (XMR) truly hybrid system with higher imaging signal-to-noise ratio (SNR) and versatility than our first prototype. In our XMR design, a fixed anode X-ray fluoroscopy system is positioned between the two donut-shaped magnetic poles of a 0.5T GE Signa-SP magnet (SP-XMR). This paper describes the methods for increased compatibility between the upgraded x-ray and MR systems that have helped improve patient management.A GE OEC 9800 system (GE OEC Salt Lake City, UT) was specially reconfigured for permitting X-ray fluoroscopy inside the interventional magnet. A higher power X-ray tube, a new permanent tube mounting system, automatic exposure control (AEC), remote controlled collimators, choice of multiple frame rates, DICOM image compatibility, magnetically shimmed X-ray detector, X-ray compatible MR coil, and better RF shielding are the highlights of the new system. A total of 23 clinical procedures have been conducted with SP-XMR guidance of which five were performed using the new system.The 70% increased power for fluoroscopy, and a new 6 times higher power single frame imaging mode, has improved imaging capability. The choice of multiple imaging frame rates, AEC, and collimator control allow reduction in X-ray exposure to the patient. The DICOM formatting has permitted easy transfer of clinical images over the hospital PACS network. The increased MR compatibility of the detector and the X-ray transparent MR coil has enabled faster switching between X-ray and MR imaging modes.The improvements introduced in our SP-XMR system have further streamlined X-ray/MR hybrid imaging. Additional clinical procedures could benefit from the new SP-XMR imaging.

Abstract

The noise analysis for three-point decomposition of water and fat was extended to account for the uncertainty in the field map. This generalization leads to a nonlinear estimation problem. The Crámer-Rao bound (CRB) was used to study the variance of the estimates of the magnitude, phase, and field map by computing the maximum effective number of signals averaged (NSA) for any choice of echo time shifts. The analysis shows that the noise properties of the reconstructed magnitude, phase, and field map depend not only on the choice of echo time shifts but also on the amount of fat and water in each voxel and their alignment at the echo. The choice of echo time shifts for spin-echo, spoiled gradient echo, and steady-state free precession imaging techniques were optimized using the CRB. The noise analysis for the magnitude explains rough interfaces seen clinically in the boundary of fat and water with source images obtained symmetrically about the spin-echo. It also provides a solution by choosing appropriate echo time shifts (-pi/6+pik, pi/2+pik, 7pi/6+pik), with k an integer. With this choice of echo time shifts it is possible to achieve the maximum NSA uniformly across all fat:water ratios. The optimization is also carried out for the estimation of phase and field map. These theoretical results were verified using Monte Carlo simulations with a newly developed nonlinear least-squares reconstruction algorithm that achieves the CRB.

Abstract

To validate one possible function of a real-time x-ray/MR (XMR) interface in a hybrid XMR system using x-ray images as "scouts" to prescribe the MR slices.The registration process consists of two steps: 1) calibration, in which the system's geometric parameters are found from fiducial-based registration; and 2) application, in which the x-ray image of a target structure and the estimated geometric parameters are used to prescribe an MR slice to observe the target structure. Errors from the noise in the location of the fiducial markers, and MR gradient nonlinearity were studied. Computer simulations were used to provide guidelines for fiducial marker placement and tolerable error estimation. A least-squares-based correction method was developed to reduce errors from gradient nonlinearity.In simulations with both sources of errors and the correction for gradient nonlinearity, the use of 16 fiducial markers yielded a mean error of about 0.4 mm over a 7200 cm(3) volume. Phantom scans showed that the prescribed target slice hit most of the target line, and that the length visualized was improved with the least-squares correction.The use of 16 fiducial markers to co-register XMR FOVs can offer satisfactory accuracy in both simulations and experiments.

Abstract

An error analysis for quantifying single kidney extraction fraction (EF) via differential T1 measurements in the renal vein (RV) and renal artery (RA) is presented. Sources of error include blood flow effects, the effect of a short repetition time (TR), and the impact of uncertainties in the T1 estimates on the final EF calculations. Blood flow effects were investigated via simulation. For a range of blood velocities in the renal vein that may be found in kidney disease, incomplete refreshment of blood between readouts results in significant errors in T1 estimation. For a .5-cm slice, 110-ms sampling interval, and T1 of 600 ms, T1 estimation to within 5% of true T1 requires an average through-plane velocity of 6.75 cm/s for parabolic flow, and 3.5 cm/s for plug flow. Improvement can be achieved by accurately estimating the fraction of blood that has not refreshed between readouts (f(old)), while the quality of the T1 estimate varies with the accuracy of f(old) estimation. Shortening of the TR was investigated using phantom and in vivo studies. T1 was estimated to within 3% of the true value on phantoms, and within 5% of the true value for flowing blood for TR = 2T1. The estimated EF is shown to be very sensitive to the difference between T(1RA) and T(1RV). To achieve 10% or 20% uncertainty in the EF estimate, T1 in the renal vein and renal artery must be estimated to within approximately 1% or 2%. Because of limitations on measurement accuracy and precision, this method appears to be impractical at this time.

Abstract

To provide more complete characterization of ascending aortic blood flow, including vortex formation behind the valve cusps, in healthy subjects and patients after valve-sparing aortic root replacement (David reimplantation).Time-resolved 3-dimensional magnetic resonance imaging velocity mapping was performed to analyze pulsatile blood flow by using encoded 3-directional vector fields in the thoracic aortas of 10 volunteers and 12 patients after David reimplantation using a cylindrical tube graft (T. David I) and two versions of neosinus recreation (T. David-V and T. David-V-S mod ). Aortic flow was evaluated by using 3-dimensional time-resolved particle traces and velocity vector fields reformatted onto 2-dimensional planes. Semiquantitative data were derived by using a blinded grading system (0-3: 0, none; 1, minimal; 2, medium; 3, prominent) to analyze the systolic vortex formation behind the cusps, as well as retrograde and helical flow in the ascending aorta.Systolic vortices were seen in both coronary sinuses of all volunteers (greater in the left sinus [2.5 +/- 0.5] than the right [1.8 +/- 0.8]) but in only 4 of 10 noncoronary sinuses (0.7 +/- 0.9). Comparable coronary vortices were detected in all operated patients. Vorticity was minimal in the noncoronary cusp in T. David-I repairs (0.7 +/- 0.7) but was prominent in T. David-V noncoronary graft pseudosinuses (1.5 +/- 0.6; P = .035). Retrograde flow (P = .001) and helicity (P = .028) were found in all patients but were not distinguishable from normal values in the T. David-V-S mod patients.Coronary cusp vorticity was preserved after David reimplantation, regardless of neosinus creation. Increased retrograde flow and helicity were more prominent in T. David-V patients. These novel magnetic resonance imaging methods can assess the clinical implications of altered aortic flow dynamics in patients undergoing various types of valve-sparing aortic root replacement.

Abstract

A hybrid system that combines an x-ray fluoroscopic system and a magnetic resonance (MR) system can provide physicians with the synergy of exquisite soft tissue contrast (from MR) and high temporal and spatial resolutions (from x ray), which may significantly benefit a number of image-guided interventional procedures. However, the system configuration may require the x-ray tube to be placed in a magnetic field, which can hinder the proper functioning of the x-ray tube by deflecting its electron beam. From knowledge of how the magnetic field affects the electron trajectories, we propose creating another magnetic field along the cathode-anode axis using either solenoids or permanent magnets to reduce the deflection of the electron beam for two cases: a strong and slightly misaligned field or a weak field that is arbitrary in direction. Theoretical analysis is presented and the electron beam is simulated in various external magnetic fields with a finite element modeling program. Results show that both correction schemes enhance the robustness of the x-ray tube operation in an externally applied magnetic field.

Abstract

To decompose multicoil CINE steady-state free precession (SSFP) cardiac images acquired at short echo time (TE) increments into separate water and fat images, using an iterative least-squares "Dixon" (IDEAL) method.Multicoil CINE IDEAL-SSFP cardiac imaging was performed in three volunteers and 15 patients at 1.5 T.Measurements of signal-to-noise ratio (SNR) matched theoretical expectations and were used to optimize acquisition parameters. TE increments of 0.9-1.0 msec permitted the use of repetition times (TRs) of 5 msec or less, and provided good SNR performance of the water-fat decomposition, while maintaining good image quality with a minimum of banding artifacts. Images from all studies were evaluated for fat separation and image quality by two experienced radiologists. Uniform fat separation and diagnostic image quality was achieved in all images from all studies. Examples from volunteers and patients are shown.Multicoil IDEAL-SSFP imaging can produce high quality CINE cardiac images with uniform water-fat separation, insensitive to Bo inhomogeneities. This approach provides a new method for reliable fat-suppression in cardiac imaging.

Abstract

Minimally invasive procedures are increasing in variety and frequency, facilitated by advances in imaging technology. Our hybrid imaging system (GE Apollo flat panel, custom Brand x-ray static anode x-ray tube, GE Lunar high-frequency power supply and 0.5 T Signa SP) provides both x-ray and MR imaging capability to guide complex procedures without requiring motion of the patient between two distant gantries. The performance of the x-ray tube in this closely integrated system was evaluated by modeling and measuring both the response of the filament to an externally applied field and the behavior of the electron beam for field strengths and geometries of interest. The performance of the detector was assessed by measuring the slanted-edge modulation transfer function (MTF) and when placed at zero field and at 0.5 T. Measured resonant frequencies of filaments can be approximated using a modified vibrating beam model, and were at frequencies well below the 25 kHz frequency of our generator for our filament geometry. The amplitude of vibration was not sufficient to cause shorting of the filament during operation within the magnetic field. A simple model of electrons in uniform electric and magnetic fields can be used to estimate the deflection of the electron beam on the anode for the fields of interest between 0.2 and 0.5 T. The MTF measured at the detector and the DQE showed no significant difference inside and outside of the magnetic field. With the proper modifications, an x-ray system can be fully integrated with a MR system, with minimal loss of image quality. Any x-ray tube can be assessed for compatibility when placed at a particular location within the field using the models. We have also concluded that a-Si electronics are robust against magnetic fields. Detailed knowledge of the x-ray system installation is required to provide estimates of system operation.

Abstract

The range of RF coils that can be used in combined X-ray/MR (XMR) systems is limited because many conventional coils contain highly X-ray attenuating materials that are visible in the X-ray images and potentially obscure patient anatomy. In this study, an X-ray compatible coil design that has minimal X-ray attenuation in the field of view (FOV) of the X-ray image is presented. In this design, aluminum is used for the loop conductor and discrete elements of the coil are eliminated from the X-ray FOV. A surface coil and an abdominal phased array coil were built using the X-ray compatible design. X-ray attenuation and MR imaging properties of the coils were evaluated and compared to conventional coils. The X-ray compatible phased array coil was used to image patients during two interventional procedures in the XMR system. The X-ray compatible coils allowed for fluoroscopic X-ray image acquisition, without degradation by the coil, while maintaining excellent MR imaging qualities.

Abstract

To evaluate the performance of a combined hybrid radiography/magnetic resonance (MR) unit to guide portal vein (PV) puncture during human transjugular intrahepatic portosystemic shunt (TIPS) creation.Fourteen patients undergoing TIPS creation were studied during standard clinical applications. Patients were anesthetized and then positioned in an open MR unit containing a flat-panel radiographic fluoroscopic unit. With use of a combination of fluoroscopy and MR imaging, the PV was accessed and the TIPS procedure was performed. A noncovered nitinol stent or a covered stent-graft was placed in the TIPS tract. Number of punctures required, total procedure time, fluoroscopy time, procedural success rate, complications, and ultrasonographic and clinical follow-up were recorded.Clinical success was obtained in 13 of 14 patients. In one patient, extrahepatic puncture of the PV occurred, resulting in hemorrhage and requiring placement of a covered stent to control the bleeding. The mean number of punctures required to access the PV was 2.6 +/- 1.7, and the total procedure time was 2.5 hours +/- 0.6. Mean fluoroscopy time was 22.3 minutes +/- 5.5. Results of clinical and ultrasonographic follow-up compare favorably to previously published reports.TIPS creation with a combination hybrid radiography/MR unit is feasible and may reduce the number of needle passes required and radiation exposure, with similar overall outcomes compared with studies reported in the literature.

Abstract

To present a pictorial description of the origin of flow effects in balanced steady-state free precession (SSFP) imaging that can result in considerable frequency offset-dependent signal changes originating from outflow of spins that can still contribute to the total SSFP signal (out-of-slice contributions), to analyze the parameter dependence and slice broadening associated with outflow effects, and to illustrate clinical implications such as frequency offset-dependent flow artifacts and spatial misencoding.Computer simulations were used to create a pictorial description of flow effects that illustrates the origin and parameter dependence of the observed signal changes and links their frequency dependency to the phase distribution of spins flowing in and out of the imaging slice. Slice broadening associated with out-of-slice contributions and flow-related signal enhancement was characterized by an effective slice thickness, which depends on flow rate, the T2* decay of signal magnitude from spins that have left the imaging slice, and the ratio of the net out-of-slice magnetization relative to the thickness of the imaging slice.Both simulated SSFP signal intensities and effective slice broadening vary with flip angle and demonstrate a nonlinear dependence on inflow. Simulations with bloodlike T1 and T2 show that the effective slice thickness can be as large as 15 times the prescribed slice thickness. These effects can have significant clinical implications such as large frequency offset-dependent signal enhancement, pulsatile flow artifacts, and spatial misrepresentation of blood signal that has already left the imaging slice.Flow-related signal changes in SSFP imaging exhibit highly complex parameter dependence, which predominantly has to be associated with frequency offset-dependent outflow effects and a resulting broadening of the slice thickness.

Abstract

We propose an inverse-geometry volumetric CT system for acquiring a 15-cm volume in one rotation with negligible cone-beam artifacts. The system uses a large-area scanned source and a smaller detector array. This note describes two feasibility investigations. The first examines data sufficiency in the transverse planes. The second predicts the signal-to-noise ratio (SNR) compared to a conventional scanner. Results showed sufficient sampling of the full volume in less than 0.5 s and, when compared to a conventional scanner operating at 24 kW with a 0.5-s voxel illumination time (e.g., 0.5-s gantry rotation and pitch of one), predicted a relative SNR of 76%.

Abstract

Artery wall motion and strain play important roles in vascular remodeling and may be important in the pathogenesis of vascular disease. In vivo observations of circumferentially nonuniform wall motion in the human aorta suggest that nonuniform strain may contribute to the localization of vascular pathology. A velocity-based method to investigate circumferential strain variations was previously developed and validated in vitro; the current study was undertaken to determine whether accurate displacement and strain fields can be calculated from velocity data acquired in vivo. Wall velocities in the porcine thoracic aorta were quantified with PC-MRI and an implanted coil and were then time-integrated to compute wall displacement trajectories and cyclic strain. Displacement trajectories were consistent with observed aortic wall motion and with the displacements of markers in the aortic wall. The mean difference between velocity-based and marker-based trajectory points was 0.1 mm, relative to an average pixel size of 0.4 mm. Propagation of error analyses based on the precision of the computed displacements were used to demonstrate that 10% strain results in a standard deviation of 3.6%. This study demonstrates that it is feasible to accurately quantify strain from low wall velocities in vivo and that the porcine thoracic aorta does not deform uniformly.

Abstract

An analysis of thoracic aortic blood flow in normal subjects and patients with aortic pathologic findings is presented. Various visualization tools were used to analyze blood flow patterns within a single 3-component velocity volumetric acquisition of the entire thoracic aortaTime-resolved, 3-dimensional phase-contrast magnetic resonance imaging (3D CINE PC MRI) was employed to obtain complete spatial and temporal coverage of the entire thoracic aorta combined with spatially registered 3-directional pulsatile blood flow velocities. Three-dimensional visualization tools, including time-resolved velocity vector fields reformatted to arbitrary 2-dimensional cut planes, 3D streamlines, and time-resolved 3D particle traces, were applied in a study with 10 normal volunteers. Results from 4 patient examinations with similar scan prescriptions to those of the volunteer scans are presented to illustrate flow features associated with common pathologic findings in the thoracic aorta.Previously reported blood flow patterns in the thoracic aorta, including right-handed helical outflow, late systolic retrograde flow, and accelerated passage through the aortic valve plane, were visualized in all volunteers. The effects of thoracic aortic disease on spatial and temporal blood flow patterns are illustrated in clinical cases, including ascending aortic aneurysms, aortic regurgitation, and aortic dissection.Time-resolved 3D velocity mapping was successfully applied in a study of 10 healthy volunteers and 4 patients with documented aortic pathologic findings and has proven to be a reliable tool for analysis and visualization of normal characteristic as well as pathologic flow features within the entire thoracic aorta.

Abstract

This work describes a new approach to multipoint Dixon fat-water separation that is amenable to pulse sequences that require short echo time (TE) increments, such as steady-state free precession (SSFP) and fast spin-echo (FSE) imaging. Using an iterative linear least-squares method that decomposes water and fat images from source images acquired at short TE increments, images with a high signal-to-noise ratio (SNR) and uniform separation of water and fat are obtained. This algorithm extends to multicoil reconstruction with minimal additional complexity. Examples of single- and multicoil fat-water decompositions are shown from source images acquired at both 1.5T and 3.0T. Examples in the knee, ankle, pelvis, abdomen, and heart are shown, using FSE, SSFP, and spoiled gradient-echo (SPGR) pulse sequences. The algorithm was applied to systems with multiple chemical species, and an example of water-fat-silicone separation is shown. An analysis of the noise performance of this method is described, and methods to improve noise performance through multicoil acquisition and field map smoothing are discussed.

Abstract

Renal extraction fraction (EF) is the percentage of plasma entering the glomerulus which is filtered. Contrast agents which are freely filtered and neither secreted nor reabsorbed, may be used as markers for renal filtration, allowing EF to be calculated from computed tomography (CT) measurements of systemic vessels and renal veins. CT scans of 10 adult patients having no known renal disease were studied in this manner, giving EF values averaging 12.6% and 12.3% for the right and left kidneys, respectively, compared to the accepted value of 15%-20%. EF measurement using CT may provide noninvasive evaluation of renal function, complementing CT-derived morphologic information.

Abstract

An analysis of the effect of flow on 2D fully balanced steady state free precession (SSFP) imaging is presented. Transient and steady-state SSFP signal intensities in the presence of steady and pulsatile flow were simulated using a matrix formalism based on the Bloch equations. Various through-plane flow waveforms and rates were modeled numerically considering factors such as the excitation slice profile and both in- and out-flow effects. Phantom measurements in an experimental setup that allowed the assessment of SSFP signal properties as a function of frequency offset and flow rate demonstrated that the computer simulations provided a suitable description of the effects of flow in SSFP imaging. A volunteer scan was performed to provide in vivo validations. For accurate modeling of SSFP signal intensities it is crucial to include effects such as imperfect slice profiles and, more importantly, "out-of-slice" contributions to the signal. Both simulations and experiments show that there can be considerably large-frequency offset dependent-signal contributions from flowing spins that have already left the imaging slice but still add to the SSFP signal. Although spins leaving the slice do not experience additional RF-excitation, gradient activity is not confined to the region of excitations and the balanced nature of the SSFP imaging gradients allows "out-of-slice" transverse magnetization to contribute to the total SSFP signal, effectively by broadening the slice thickness for flowing spins. This results in a frequency dependence of in-flow related signal enhancement and flow artifacts.

Abstract

The use of a new hybrid imaging system for guidance of a brain biopsy is described. The system combines the strengths of MRI (soft-tissue contrast, arbitrary plane selection) with those of x-ray fluoroscopy (high-resolution real-time projection images, clear portrayal of bony structures) and allows switching between the imaging modalities without moving the patient. The biopsy was carried out using x-ray guidance for direction of the needle through the foramen ovale and MR guidance to target the soft-tissue lesion. Appropriate samples were acquired. The system could be particularly effective for guidance of those cases where motion, swelling, resection and other intra-operative anatomical changes cannot be accounted for using traditional stereotactic-based imaging approaches.

Abstract

To characterize gradient field nonuniformity and its effect on velocity encoding in phase contrast (PC) MRI, a generalized model that describes this phenomenon and enables the accurate reconstruction of velocities is presented. In addition to considerable geometric distortions, inhomogeneous gradient fields can introduce deviations from the nominal gradient strength and orientation, and therefore spatially-dependent first gradient moments. Resulting errors in the measured phase shifts used for velocity encoding can therefore cause significant deviations in velocity quantification. The true magnitude and direction of the underlying velocities can be recovered from the phase difference images by a generalized PC velocity reconstruction, which requires the acquisition of full three-directional velocity information. The generalized reconstruction of velocities is applied using a matrix formalism that includes relative gradient field deviations derived from a theoretical model of local gradient field nonuniformity. In addition, an approximate solution for the correction of one-directional velocity encoding is given. Depending on the spatial location of the velocity measurements, errors in velocity magnitude can be as high as 60%, while errors in the velocity encoding direction can be up to 45 degrees. Results of phantom measurements demonstrate that effects of gradient field nonuniformity on PC-MRI can be corrected with the proposed method.

Abstract

Nonuniformities of magnetic field gradients can cause serious artifacts in diffusion imaging. While it is well known that nonlinearities of the imaging gradients lead to image warping, those imperfections can also cause spatially dependent errors in the direction and magnitude of the diffusion encoding. This study shows that the potential errors in diffusion imaging are considerable. Further, we show that retrospective corrections can be applied to reduce these errors. A general mathematical framework was formulated to characterize the contribution of gradient nonuniformities to diffusion experiments. The gradient field was approximated using spherical harmonic expansion, and this approximation was employed (after geometric distortions were eliminated) to predict and correct the errors in diffusion encoding. Before the corrections were made, the experiments clearly revealed marked deviations of the calculated diffusivity for fields of view (FOVs) generally used in diffusion experiments. These deviations were most significant farther away from the magnet's isocenter. For an FOV of 25 cm, the resultant errors in absolute diffusivity ranged from approximately -10% to +20%. Within the same FOV, the diffusion-encoding direction and the orientation of the calculated eigenvectors can be significantly altered if the perturbations by the gradient nonuniformities are not considered. With the proposed correction scheme, most of the errors introduced by gradient nonuniformities can be removed.

Abstract

Phantom and in vitro studies were performed to evaluate the potential application of digital circular tomosynthesis in imaging of the breast and upper cervical spine. A prototype volumetric x-ray system was used to image a mammographic phantom, a fresh mastectomy specimen, and a head phantom containing the upper cervical spine. Results show that breast tissue visualization is improved by the ability to produce sectional images that blur overlying structures and yield three-dimensional information about calcification clusters. In upper cervical spine imaging, digital circular tomosynthesis effectively blurs overlying jaw and skull structures so that C1 and C2 can be visualized in a standard anteroposterior view.

Abstract

Many imaging experiments involve acquiring a time series of images. To improve imaging speed, several "data-sharing" methods have been proposed, which collect one (or a few) high-resolution reference(s) and a sequence of reduced data sets. In image reconstruction, two methods, known as "Keyhole" and reduced-encoding imaging by generalized-series reconstruction (RIGR), have been used. Keyhole fills in the unmeasured high-frequency data simply with those from the reference data set(s), whereas RIGR recovers the unmeasured data using a generalized series (GS) model, of which the basis functions are constructed based on the reference image(s). This correspondence presents a fast algorithm (and two extensions) for GS-based image reconstruction. The proposed algorithms have the same computational complexity as the Keyhole algorithm, but are more capable of capturing high-resolution dynamic signal changes.

Abstract

A technique for measuring velocity is presented that combines cine phase contrast (PC) MRI and balanced steady-state free precession (SSFP) imaging, and is thus termed PC-SSFP. Flow encoding was performed without the introduction of additional velocity encoding gradients in order to keep the repetition time (TR) as short as in typical SSFP imaging sequences. Sensitivity to through-plane velocities was instead established by inverting (i.e., negating) all gradients along the slice-select direction. Velocity sensitivity (VENC) could be adjusted by altering the first moments of the slice-select gradients. Disturbances of the SSFP steady state were avoided by acquiring different flow echoes in consecutively (i.e., sequentially) executed scans, each over several cardiac cycles, using separate steady-state preparation periods. A comparison of phantom measurements with those from established 2D-cine-PC MRI demonstrated excellent correlation between both modalities. In examinations of volunteers, PC-SSFP exhibited a higher intrinsic signal-to-noise ratio (SNR) and consequently low phase noise in measured velocities compared to conventional PC scans. An additional benefit of PC-SSFP is that it relies less on in-flow-dependent signal enhancement, and thus yields more uniform SNRs and better depictions of vessel geometry throughout the whole cardiac cycle in structures with slow and/or pulsatile flow.

Abstract

To demonstrate the feasibility of a four-dimensional phase contrast (PC) technique that permits spatial and temporal coverage of an entire three-dimensional volume, to quantitatively validate its accuracy against an established time resolved two-dimensional PC technique to explore advantages of the approach with regard to the four-dimensional nature of the data.Time-resolved, three-dimensional anatomical images were generated simultaneously with registered three-directional velocity vector fields. Improvements compared to prior methods include retrospectively gated and respiratory compensated image acquisition, interleaved flow encoding with freely selectable velocity encoding (venc) along each spatial direction, and flexible trade-off between temporal resolution and total acquisition time.The implementation was validated against established two-dimensional PC techniques using a well-defined phantom, and successfully applied in volunteer and patient examinations. Human studies were performed after contrast administration in order to compensate for loss of in-flow enhancement in the four-dimensional approach.Advantages of the four-dimensional approach include the complete spatial and temporal coverage of the cardiovascular region of interest and the ability to obtain high spatial resolution in all three dimensions with higher signal-to-noise ratio compared to two-dimensional methods at the same resolution. In addition, the four-dimensional nature of the data offers a variety of image processing options, such as magnitude and velocity multi-planar reformation, three-directional vector field plots, and velocity profiles mapped onto selected planes of interest.

Abstract

In vivo quantification of vessel wall cyclic strain has important applications in physiology and disease research and the design of intravascular devices. We describe a method to calculate vessel wall strain from cine PC-MRI velocity data. Forward-backward time integration is used to calculate displacement fields from the velocities, and cyclic Green-Lagrange strain is computed in segments defined by the displacements. The method was validated using a combination of in vitro cine PC-MRI and marker tracking studies. Phantom experiments demonstrated that wall displacements and strain could be calculated accurately from PC-MRI velocity data, with a mean displacement difference of 0.20 +/- 0.16 mm (pixel size 0.39 mm) and a mean strain difference of 0.01 (strain extent 0.20). A propagation of error analysis defined the relationship between the standard deviations in displacements and strain based on original segment length and strain magnitude. Based on the measured displacement standard deviation, strain standard deviations were calculated to be 0.015 (validation segment length) and 0.045 (typical segment length). To verify the feasibility of using this method in vivo, cyclic strain was calculated in the thoracic aorta of a normal human subject. Results demonstrated nonuniform deformation and circumferential variation in cyclic strain, with a peak average strain of 0.08 +/- 0.11.

Abstract

In planning operations for patients with cardiovascular disease, vascular surgeons rely on their training, past experiences with patients with similar conditions, and diagnostic imaging data. However, variability in patient anatomy and physiology makes it difficult to quantitatively predict the surgical outcome for a specific patient a priori. We have developed a simulation-based medical planning system that utilizes three-dimensional finite-element analysis methods and patient-specific anatomic and physiologic information to predict changes in blood flow resulting from surgical bypass procedures. In order to apply these computational methods, they must be validated against direct experimental measurements. In this study, we compared in vivo flow measurements obtained using magnetic resonance imaging techniques to calculated flow values predicted using our analysis methods in thoraco-thoraco aortic bypass procedures in eight pigs. Predicted average flow rates and flow rate waveforms were compared for two locations. The predicted and measured waveforms had similar shapes and amplitudes, while flow distribution predictions were within 10.6% of the experimental data. The average absolute difference in the bypass-to-inlet blood flow ratio was 5.4 +/- 2.8%. For the aorta-to-inlet blood flow ratio, the average absolute difference was 6.0 +/- 3.3%.

Abstract

TRICKS is an acquisition and reconstruction method capable of generating 3D time-resolved angiograms. Arguably, the main problem with TRICKS is the way it handles the outer regions of the k-space matrix, leading to artifacts at the edges of blood vessels. An alternative to the data- processing stage of TRICKS, designed to better represent edges and small vessels, is presented here. A weakness of the new approach is an increased sensitivity to motion compared to TRICKS. Since this method can use the same data as TRICKS, a hybrid reconstruction method could conceivably be developed where the advantages of both approaches are combined. Magn Reson Med 47:1022-1025, 2002.

Abstract

To determine the feasibility of using magnetic resonance imaging (MRI) to non-invasively measure strain in the aortic wall.Cine phase contrast MRI was used to measure the velocity of the aortic wall and calculate changes in circumferential strain over the cardiac cycle. A deformable vessel phantom was used for initial testing and in vitro validation. Ultrasonic sonomicrometer crystals were attached to the vessel wall and used as a gold standard.In the in vitro validation, MRI-calculated wall displacements were within 0.02 mm of the sonomicrometer measurements when maximal displacement was 0.28 mm. The measured maximum strain in vitro was 0.02. The in vivo results were on the same order as prior results using ultrasound echo-tracking.Results of in vivo studies and measurement of cyclic strain in human thoracic and abdominal aortas demonstrate the feasibility of the technique.

Abstract

The purpose of this study was to provide in vivo demonstrations of the functionality of a truly hybrid interventional x-ray/magnetic resonance (MR) system.A digital flat-panel x-ray system (1,024(2) array of 200 microm pixels, 30 frames per second) was integrated into an interventional 0.5-T magnet. The hybrid system is capable of MR and x-ray imaging of the same field of view without patient movement. Two intravascular procedures were performed in a 22-kg porcine model: placement of a transjugular intrahepatic portosystemic shunt (TIPS) (x-ray-guided catheterization of the hepatic vein, MR fluoroscopy-guided portal puncture, and x-ray-guided stent placement) and mock chemoembolization (x-ray-guided subselective catheterization of a renal artery branch and MR evaluation of perfused volume).The resolution and frame rate of the x-ray fluoroscopy images were sufficient to visualize and place devices, including nitinol guidewires (0.016-0.035-inch diameter) and stents and a 2.3-F catheter. Fifth-order branches of the renal artery could be seen. The quality of both real-time (3.5 frames per second) and standard MR images was not affected by the x-ray system. During MR-guided TIPS placement, the trocar and the portal vein could be easily visualized, allowing successful puncture from hepatic to portal vein.Switching back and forth between x-ray and MR imaging modalities without requiring movement of the patient was demonstrated. The integrated nature of the system could be especially beneficial when x-ray and MR image guidance are used iteratively.

Abstract

In phocid seals, an increase in hematocrit (Hct) accompanies diving and periods of apnea. The variability of phocid Hct suggests that the total red cell mass is not always in circulation, leading researchers to speculate on the means of blood volume partitioning. The histology and disproportionate size of the phocid spleen implicates it as the likely site for RBC storage. We used magnetic resonance imaging on Northern elephant seals to demonstrate a rapid contraction of the spleen and a simultaneous filling of the hepatic sinus during forced dives (P < 0.0001, R(2) = 0.97). The resulting images are clear evidence demonstrating a functional relationship between the spleen and hepatic sinus. The transfer of blood from the spleen to the sinus provides an explanation for the disparity between the timing of diving-induced splenic contraction ( approximately 1-3 min) and the occurrence of peak Hct (15-25 min). Facial immersion was accompanied by an immediate and profound splenic contraction, with no further significant decrease in splenic volume after min 2 (Tukey-Kramer HSD, P = 0.05). At the conclusion of the dive, the spleen had contracted to 16% of its predive volume (mean resting splenic volume = 3,141 ml +/- 68.01 ml; 3.54% of body mass). In the postdive period, the spleen required 18-22 min to achieve resting volume, indicating that this species may not have sufficient time to refill the spleen when routinely diving at sea, which is virtually continuous with interdive surface intervals between 1 and 3 min.

Abstract

A test-bed system has been developed for imaging phantoms with tomosynthesis and volumetric computed tomography. This system incorporates an amorphous silicon flat panel detector on a movable gantry and a computer-controlled rotational positioning stage. In this paper, an analysis of the sensitivity of reconstructed images to geometrical misalignment is presented. Application of this method to circular digital tomosynthesis is examined, with spatial resolution in the focal plane as the criterion for evaluating the effect of misalignment. A software-based method is presented for correcting data for imperfect system alignment prior to image reconstruction. Experimental results yield reconstructed images with spatial resolution approaching the theoretical limit based on detector pixel size and accounting for data interpolation.

Abstract

Three parallel-imaging methods were implemented and compared in terms of artifact and noise content: original SMASH, Cartesian SENSE, and an extremely simple method called here the "scissors method." These methods represent very different approaches to the parallel-imaging problem. The experimental and numerical comparisons presented here aim at shedding light on the whole spectrum of parallel-imaging methods, not just the three methods actually implemented. In our results, SMASH images had an artifact level significantly higher than SENSE images for all acceleration factors. The SNR in SENSE images was nearly optimal at low acceleration factors. As acceleration was increased, the noise content in SENSE images eventually sharply departed from optimal values, while the artifact content remained low.

Abstract

A filtering technique has been developed to modify the three-dimensional impulse response of circular motion tomosynthesis to allow the generation of images whose appearance is like those of some other imaging geometries. In particular, this technique can reconstruct images with a blurring function which is more homogeneous for off-focal plane objects than that from circular tomosynthesis. In this paper, we describe the filtering process, and demonstrate the ability to alter the impulse response in circular motion tomosynthesis from a ring to a disk. This filtering may be desirable because the blurred out-of-plane objects appear less structured.

Abstract

A system enabling both x-ray fluoroscopy and MRI in a single exam, without requiring patient repositioning, would be a powerful tool for image-guided interventions. We studied the technical issues related to acquisition of x-ray images inside an open MRI system (GE Signa SP). The system includes a flat-panel x-ray detector (GE Medical Systems) placed under the patient bed, a fixed-anode x-ray tube overhead with the anode-cathode axis aligned with the main magnetic field and a high-frequency x-ray generator (Lunar Corp.). New challenges investigated related to: 1) deflection and defocusing of the electron beam of the x-ray tube; 2) proper functioning of the flat panel; 3) effects on B0 field homogeneity; and 4) additional RF noise in the MR images. We have acquired high-quality x-ray and MR images without repositioning the object using our hybrid system, which demonstrates the feasibility of this new configuration. Further work is required to ensure that the highest possible image quality is achieved with both MR and x-ray modalities.

Abstract

A new energy-dependent multi-cell detector, which is a generalization of the conventional front-back detector, was studied using computer simulations. The noise performance of the detector for bone quantitation was examined in comparison to an ideal energy discriminating detector, and front-back detectors with and without inter-detector filters. The front-back detectors were optimized for a reference object composed of water and bone, and then compared to the new detector over a range of object compositions. In this paper, precision in calculated bone thickness is used as the criterion for evaluating detector performance. Simulations show that the segmented detector always performs better than the front-back detector without an inter-detector filter. It outperforms the detector incorporating a filter by an amount that depends on the heterogeneity of the x-ray spectrum. In addition, for single component radiographic images, this multi-cell detector retains information which is lost in the front-back detector with a filter layer.

Abstract

In some dynamic applications of MRI, only a part of the field-of-view (FOV) actually undergoes dynamic changes. A class of methods, called reduced-FOV (rFOV) methods, convert the knowledge that some part of the FOV is static or not very dynamic into an increase in temporal resolution for the dynamic part, or into a reduction in the scan time. Although cardiac imaging is an important example of an imaging situation where changes are concentrated in a fraction of the FOV, the rFOV methods developed up to now are not compatible with one of the most common cardiac sequences, the so-called retrospective cine method. The present work is a rFOV method designed to be compatible with cine imaging. An increase by a factor n in temporal resolution or a decrease by n in scan time is obtained in the case where only one nth of the FOV is dynamic (the rest being considered static). Results are presented for both Cartesian and spiral imaging.

Abstract

The purpose of this study was to assess image quality of three-dimensional (3D) cardiac cine magnetic resonance (MR) imaging before and after administration of a T1-shortening ultrasmall superparamagnetic iron oxide blood pool agent (NC100150). 3D cardiac cine MR imaging was performed in 13 volunteers using a radiofrequency-spoiled cardiac-gated 3D cine gradient-echo sequence with short repetition and echo times. Compared with precontrast images, postcontrast images showed no enhancement in fat and skeletal muscle, moderate enhancement in myocardium, and significant enhancement in ventricular cavity. After contrast injection, the signal ratio of the ventricular chamber to the myocardium significantly increased, and dramatic improvements were seen in the quality of the cineangiographic images and the depiction of cardiac valves. This quantitative study has shown that 3D cardiac cine MR imaging using a blood pool agent provided MR ventriculography and cineangiography with excellent image quality.

Abstract

In several applications, MRI is used to monitor the time behavior of the signal in an organ of interest; e.g., signal evolution because of physiological motion, activation, or contrast-agent accumulation. Dynamic applications involve acquiring data in a k-t space, which contains both temporal and spatial information. It is shown here that in some dynamic applications, the t axis of k-t space is not densely filled with information. A method is introduced that can transfer information from the k axes to the t axis, allowing a denser, smaller k-t space to be acquired, and leading to significant reductions in the acquisition time of the temporal frames. Results are presented for cardiac-triggered imaging and functional MRI (fMRI), and are compared with data obtained in a conventional way. The temporal resolution was increased by nearly a factor of two in the cardiac-triggered study, and by as much as a factor of eight in the fMRI study. This increase allowed the acquisition of fMRI activation maps, even when the acquisition time for a single full time frame was actually longer than the paradigm cycle period itself. The new method can be used to significantly reduce the acquisition time of the individual temporal frames in certain dynamic studies. This can be used, for example, to increase the temporal or spatial resolution, increase the spatial coverage, decrease the total imaging time, or alter sequence parameters e.g., repetition time (TR) and echo time (TE) and thereby alter contrast. Magn Reson Med 42:813-828, 1999.

Abstract

We present a method (DMESH) for nonrigid cyclic motion analysis using a series of velocity images covering the cycle acquired, for example, from phase-contrast magnetic resonance imaging. The method is based on fitting a dynamic finite-element mesh model to velocity samples of an extended region, at all time frames. The model offers a flexible tradeoff between accuracy and reproducibility with controllable built-in spatiotemporal smoothing, which is determined by the fineness of the initially defined mesh and the richness of included Fourier harmonics. The method can further provide a prediction of the analysis reproducibility, along with the estimated motion and deformation quantities. Experiments have been conducted to validate the method and to verify the reproducibility prediction. Use of the method for motion analysis using displacement information (e.g., from magnetic resonance tagging) has also been explored.

Abstract

We describe a technique for three-dimensional cine MR imaging. By using short repetition times (TR) and interleaved slice encoding, volumetric cine data can be acquired throughout the cardiac cycle with a temporal resolution of approximately 80 msec. A T1-shortening agent is used to produce contrast between blood and myocardium. A comparison between the acquisition times of this and several other two-dimensional techniques is presented.

Abstract

Motion tracking based on single-slice cine-phase contrast magnetic resonance imaging data has limitations. In the presence of nontrivial three-dimensional motion and deformation, volumetric data are necessary for accurate reconstruction of material point trajectories. A three-dimensional Fourier tracking method that uses volumetric data for motion tracking is presented. The method reconstructs a material point trajectory by computing its various harmonics. For any given temporal sampling rate, a frequency domain perspective of the tracking problem indicates that the method is accurate in estimating all reconstructible harmonics of a trajectory. The algorithm incorporates an intra-voxel linear spatial model into the integration to address potential tracking performance degradation due to possibly reduced spatial resolution, which may be most relevant in the slice direction (z) if the volumetric data are obtained as multiple two-dimensional slices. The tracking method was evaluated on computer-generated data sets that simulated various motion patterns. The method was also tested with two sets of in vitro data obtained using a phantom, one acquired as multiple two-dimensional slices and the other using a three-dimensional sequence capable of higher spatial resolution in the z direction. These studies demonstrated that the algorithm can achieve high sub-voxel tracking accuracy.

Abstract

The ability to track motion from cine phase-contrast (PC) magnetic resonance (MR) velocity measurements was investigated using an in vitro model. A computer-controlled deformable phantom was used for the characterization of the accuracy and precision of the forward-backward and the compensated Fourier integration techniques. Trajectory accuracy is limited by temporal resolution when the forward-backward technique is used. With this technique the extent of the calculated trajectories is underestimated by an amount related to the motion period and the sequence repetition time, because of the band-limiting caused in the cine interpolation step. When the compensated Fourier integration technique is used, trajectory accuracy is independent of temporal resolution and is better than 1 mm for excursions of less than 15 mm, which are comparable to those observed in the myocardium. Measurement precision is dominated by the artifact level in the phase-contrast images. If no artifacts are present precision is limited by the inherent signal-to-noise ratio of the images. In the presence of artifacts, similar in magnitude to those observed in vivo, the reproducibility of tracking a 2.2 x 2.2 mm2 region of interest is better than 0.5 mm. When the Fourier integration technique is used, the improved accuracy is accompanied by a reduction in precision. We verified that tracking three-dimensional (3D) motion from velocity measurements of a single slice can lead to underestimations of the trajectory if there is a through-plane component of the motion that is not truly represented by the measured velocities. This underestimation can be overcome if volumetric cine phase-contrast velocity data are acquired and full three-dimensional analysis is performed.

Abstract

To assess the ability of three cine phase-contrast magnetic resonance (MR) imaging techniques to measure normal human renal blood flow (RBF) in vivo.Eighteen healthy volunteers were studied with three cine phase-contrast MR imaging techniques: breath-hold, segmented k-space, two-dimensional, Fourier transform technique (ie, time-resolved imaging with automatic data segmentation, or TRIADS); a breath-hold rapid spiral acquisition; and a non-breath-hold rapid spiral acquisition that allowed resolution of both cardiac and respiratory cycles. In each case, total arterial RBF and blood flow per unit of renal volume were calculated. For each subject, RBF was measured with a standard technique of p-aminohippuric acid (PAH)-clearance hematocrit on the same day as the MR imaging examination was performed.The range of agreement (2 standard deviations, or 95% confidence interval) between RBF measurements obtained with the PAH-clearance hematocrit technique and the various cine phase-contrast techniques varied from +/- 17.6% to +/- 26.5%. The best agreement was obtained with non-breath-hold rapid spiral data, by using data from the end-expiratory phase of respiration.Findings with cine phase-contrast MR imaging employing rapid spiral acquisition are in good agreement with measurements made with PAH-clearance hematocrit and give the promise of clinical measurements of RBF.

Abstract

This paper describes a technique for characterizing the gradient subsystem of a magnetic resonance (MR) system. The technique uses a Fourier-transform analysis to directly measure the k-space trajectory produced by an arbitrary gradient waveform. In addition, the method can be easily extended to multiple dimensions and can be adapted to measuring residual gradient effects such as eddy currents. Several examples of gradient waveform and eddy-current measurements are presented. Also, it is demonstrated how the eddy-current measurements can be parameterized with an impulse-response formalism for later use in system tuning. When compared to a peak-fitting analysis, this technique provides a more direct extraction of the k-space measurements, which reduces the possibility of analysis error. This approach also has several advantages as compared to the conventional eddy-current measurement technique, including the ability to measure very short time constant effects.

Abstract

Ultrafast breath-hold contrast material-enhanced magnetic resonance (MR) angiography can be performed with a flexible imaging sequence. With the current generation of high-speed imaging gradients, it is possible to achieve sequence repetition times of 4 msec or less. These repetition times make it possible to obtain high-resolution (512 x 512 x 64) images in under 30 seconds. Applications of this versatile technique include imaging of aortic dissection, thoracic and abdominal aortic aneurysm, pulmonary embolus, carotid stenosis, and peripheral vascular disease. The administration of contrast material must be tailored to the vascular anatomy under examination to avoid venous enhancement. The rapid data acquisition times can be used to image multiple temporal phases or multiple locations. With this technique and administration of a T1-shortening contrast agent, high-quality MR angiography can be routinely performed in a variety of vascular regions (eg, thoracic and abdominal aorta, pulmonary arteries, carotid arteries, lower extremities).

Abstract

Whenever a linear gradient is activated, concomitant magnetic fields with non-linear spatial dependence result. This is a consequence of Maxwell's equations, i.e., within the imaging volume the magnetic field must have zero divergence, and has negligible curl. The concomitant, or Maxwell field has been described in the MRI literature for over 10 years. In this paper, we theoretically and experimentally show the existence of two additional lowest-order terms in the concomitant field, which we call cross-terms. The concomitant gradient cross-terms only arise when the longitudinal gradient Gz is simultaneously active with a transverse gradient (Gx or Gy). The effect of all of the concomitant gradient terms on phase contrast imaging is examined in detail. Several methods for reducing or eliminating phase errors arising from the concomitant magnetic field are described. The feasibility of a joint pulse sequence-reconstruction method, which requires no increase in minimum TE, is demonstrated. Since the lowest-order terms of the concomitant field are proportional to G2/B0, the importance of concomitant gradient terms is expected to increase given the current interest in systems with stronger gradients and/or weaker main magnetic fields.

Abstract

Phase contrast magnetic resonance imaging (MRI) can provide in vivo myocardial velocity field measurements. These data allow densely spaced material points to be tracked throughout the whole heart cycle using, for example, the Fourier tracking algorithm. To process the tracking results for myocardial deformation and strain quantification, we developed a method that is based on fitting the tracking results to an appropriate local deformation model. We further analyzed the accuracy and precision of the method and provided performance predictions for several local models. In order to validate the method and the theoretical performance analysis, we conducted controlled computer simulations and a phantom study. The results agreed well with expectations. Human heart data were also acquired and analyzed, and provided encouraging results. At the signal-to-noise ratio (SNR) level and spatial resolution expected in clinical settings, the study predicts strain quantification accuracy and precision that may allow the technique to become a practical and powerful noninvasive approach for the study of cardiac function, although clinically acceptable data acquisition strategies for three-dimensional (3-D) data are still a challenge.

Abstract

A new generation of high power gradient systems which allow much faster MR imaging as well as shorter echo times has recently become available. Some of these high-speed gradient systems impose limits on the percentage of time during which the gradient can change in amplitude (slewing duty cycle). While this limitation may be immaterial to many 2DFT and echo planar imaging methods, a traditional circular spiral trajectory is difficult to use on these systems because its gradient waveforms change during the entire course of the trajectory so that the slewing duty cycle during the readout period is 100%. We describe a piecewise-linear spiral trajectory which is composed of linear segments and rounded corners. This trajectory reduces the slewing duty cycle while maintaining the desirable imaging properties of circular spirals including interleaving by simple gradient rotation. For one representative example, the slewing duty cycle is reduced to 46%. A conventional gridding method was used for image reconstruction, but a new numerical algorithm to calculate the density compensation factor was required. Use of piecewise-linear spiral trajectories reduces the impact imposed by limited gradient slewing duty cycle.

Abstract

The reproducibility of myocardial motion trajectories calculated from cine phase-contrast (PC) velocity data is reduced by artifacts due to the inconsistent motion of intracardiac blood. Spatial presaturation reduces these artifacts but requires a longer sequence TR, with a potentially negative effect on trajectory accuracy and reproducibility. We investigated the effect of spatial presaturation on trajectory reproducibility. A mid-ventricular transaxial slice was imaged in five normal volunteers. The same slice was imaged three times each with sequences using spatial presaturation or not. Because the most serious artifacts originate in the heart chambers and propagate in the phase-encoded direction, myocardial regions that were in line with the heart chambers (in the phase-encode direction) had the highest artifact level in the scans without spatial presaturation. The reproducibility of trajectories for regions placed in these areas (the anterior wall, septum and posterior wall in the transaxial scans with phase encoding in the anterior-posterior direction) improved by a factor of two when presaturation was used (P < .001). In areas that were not in line with the heart chambers (eg, the anterior aspect of the lateral wall in the transaxial scans), the effect of presaturation was not significant. These results correlate well with the measured reduction in artifact level. The reproducibility of myocardial motion trajectories over large areas of the heart is improved to approximately 1 mm when presaturation is used. Therefore, use of presaturation is recommended for myocardial motion studies using cine PC velocity data.

Abstract

Dynamic cardiac imaging in MRI is a very challenging task. To obtain high spatial resolution, temporal resolution, and signal-to-noise ratio (SNR), single-shot imaging is not sufficient. Use of multishot techniques resolves this problem but can cause motion artifacts because of data inconsistencies between views. Motion artifacts can be reduced by signal averaging at some cost in increased scan time. However, for the same increase in scan time, other techniques can be more effective than simple averaging in reducing the artifacts. If most of the energy of the inconsistencies is limited to a certain region of kappa-space, increased sampling density (oversampling) in this region can be especially effective in reducing motion artifacts. In this work, several variable-density spiral trajectories are designed and tested. Their efficiencies for artifact reduction are evaluated in computer simulations and in scans of normal volunteers. The SNR compromise of these trajectories is also investigated. The authors conclude that variable-density spiral trajectories can effectively reduce motion artifacts with a small loss in SNR as compared with a uniform density counterpart.

Abstract

Magnetic resonance angiography (MRA) was performed by using RF pulses designed to excite a limited spatial extent in two orthogonal directions. The restriction in the second spatial dimension can be used to increase inflow enhancement and to improve small field-of-view imaging. A rectangular excitation was produced with an "echo-planar" k-space trajectory and a sinc-modulated RF waveform. In vivo images have demonstrated that vessels are more clearly delineated with the two-dimensional excitation. Aliasing artifacts in small field-of-view imaging are significantly reduced, although in some cases complete elimination is not possible due to the nature of the gradient trajectory.

Abstract

The purpose of this paper was to evaluate the use of dynamic gadopentetate dimeglumine-enhanced, breath-hold spoiled gradient-recalled (SPGR) MR imaging with cardiac compensation (CMON) compared to spin-echo MR imaging in patients with thoracic malignancy. We retrospectively reviewed MR images from 29 patients with thoracic tumors. MR imaging included axial electrocardiogram (ECG)-gated T1-weighted, fast spin echo (FSE) T2-weighted, and contrast-enhanced breath-hold fast multiplanar SPGR imaging with CMON, which selects the phase-encoding gradient based on the phase within the cardiac cycle. Images were reviewed for lung masses, mediastinal or hilar tumor, disease of the pleura, chest wall, and bones and vascular compression or occlusion. Contrast-enhanced fast multiplanar SPGR imaging with CMON produces images of the chest that are free of respiratory artifact and have diminished vascular pulsation artifact. ECG-gated T1-weighted images were preferred for depicting mediastinal and hilar tumor. The gadopentetate dimeglumine-enhanced fast multiplanar SPGR images were useful for depicting chest wall tumor, vascular compression or thrombosis, osseous metastases, and in distinguishing a central tumor mass from peripheral lung consolidation. Pleural tumor was depicted best on the FSE T2-weighted images and the contrast-enhanced SPGR images. As an adjunct to spin echo T1-weighted and T2-weighted imaging, contrast-enhanced fast multiplanar SPGR imaging with CMON is useful in the evaluation of thoracic malignancy.

Abstract

To address the need for a complex physiologic motion phantom for use in MR applications, such as the verification of techniques for measuring myocardial motion dynamics and motion insensitive pulse sequences, a computer-controlled motion phantom has been designed. The phantom, which consists of a deformable silicone gel annulus mounted on a translation stage, can undergo a range of bulk motions and deformations. Available motions include bulk rotation and translation, rotational shear, axial shear, and combinations of some or all of these motions. In this paper, the capability of the phantom to produce accurate constant and time-varying waveforms is demonstrated. In the current implementation, peak linear translation and rotation rates are 175 mm s-1 and 10 rad s-1, respectively. Cycle-to-cycle reproducibility is excellent, with variations of less than .003 radians over the period of hours while undergoing rotational shear. The phantom has been designed in a flexible fashion so that various test objects can be scanned while undergoing bulk translation and can be adapted to produce different deformations.

Abstract

A closed-form integration method is derived and analyzed for computing motion trajectories from velocity field data, particularly as measured by phase contrast (PC) cine MR imaging. By modeling periodic motion as composed of Fourier harmonics and integrating the material velocity of the tracked point in the frequency domain, this method gives an unbiased trajectory estimate in the presence of white measurement noise and eddy current effects. When applied to cine PC data, the method can incorporate compensation for the frequency response of the cine interpolation, offering a further improvement on the tracking accuracy. In simulation and phantom studies, the estimated trajectories were in excellent agreement with the true trajectories. Encouraging results have also been obtained on data from volunteers.

Abstract

In some dynamic imaging applications, only a fraction, 1/n, of the field of view (FOV) may show considerable change during the motion cycle. A method is presented that improves the temporal resolution for a dynamic region by a factor, n, while maintaining spatial resolution at a cost of square root of n in signal-to-noise ratio (SNR). Temporal resolution is improved, or alternatively, total imaging time is reduced by reducing the number of phase encodes acquired for each temporal frame by 1/n. To eliminate aliasing, a representation of the signal from the static outer portion of the FOV is constructed using all the raw data. The k-space data derived from this representation is subtracted from the original data sets, and the differences correspond to the dynamic portion of the FOV. Improved resolution results are presented in phantom studies, and in vivo phase contrast quantitative flow imaging.

Artifacts and signal loss due to flow in the presence of B-0 inhomogeneityMAGNETIC RESONANCE IN MEDICINEDrangova, M., Pelc, N. J.1996; 35 (1): 126-130

Abstract

An in vitro study was performed to investigate the effects of B(o) inhomogeneity on magnetic resonance images of flow. Controlled inhomogeneity gradients (Gi) were applied and the magnitude of the artifacts produced was quantified for different echo delay times (TE). Both steady and pulsatile flows were examined. In the presence of an inhomogeneity gradient, signal loss is apparent if the flow is pulsatile and/or if the slice thickness is large. The signal loss increases with increasing TE and Gi. With pulsatile flow, ghosting artifacts are also generated. These increase in intensity with increasing TE and Gi. In vivo, field inhomogeneity due to susceptibility variations is large enough to produce these effects. Representative time-of-flight images obtained of a normal volunteer with two different TEs demonstrate the effect in vivo. Flow-related signal loss and artifacts, therefore, increase with increasing TE independent of the moments of the applied gradients.

Abstract

Interleaved spiral scanning of k-space is an efficient and fast method for imaging dynamic processes. In this article, a cine version of interleaved spiral imaging is presented. The method is shown to overcome the "lightning-flash" artifacts of the conventional triggered (gated) method. Compared with the segmented k-space 2DFT method, it achieves better temporal resolution in a comparable or shorter scan time. Preliminary human studies show that the method is a promising tool for imaging dynamic processes.

Abstract

The sensitivity of nuclear magnetic resonance to motion can be harnessed to produce quantitative measurements of low flow velocity and volume flow rate. MR flow quantification is noninvasive, can be performed in arbitrary locations and in any image orientation, and is fairly rapid. This article discusses the basic techniques with particular attention to phase contrast quantitation of volume flow rate, especially the determinants of accuracy and reproducibility in these measurements.

Abstract

A method of computing trajectories of objects by using velocity data, particularly as acquired with phase-contrast magnetic resonance (MR) imaging, is presented. Starting from a specified location at one time point, the method recursively estimates the trajectory. The effects of measurement noise and eddy current-induced velocity offsets are analyzed. When the motion is periodic, trajectories can be computed by integrating in both the forward and backward temporal directions, and a linear combination of these trajectories minimizes the effect of velocity offsets and maximizes the precision of the combined trajectory. For representative acquisition parameters and signal-to-noise ratios, the limitations due to measurement noise are acceptable. In a phantom with reciprocal rotation, the measured and true trajectories agreed to within 3.3%. Sample trajectory estimates of human myocardial regions are encouraging.

Abstract

The authors have developed a technique based on a solution of the Poisson equation to unwrap the phase in magnetic resonance (MR) phase images. The method is based on the assumption that the magnitude of the inter-pixel phase change is less than pi per pixel. Therefore, the authors obtain an estimate of the phase gradient by "wrapping" the gradient of the original phase image. The problem is then to obtain the absolute phase given the estimate of the phase gradient. The least-squares (LS) solution to this problem is shown to be a solution of the Poisson equation allowing the use of fast Poisson solvers. The absolute phase is then obtained by mapping the LS phase to the nearest multiple of 2 K from the measured phase. The proposed technique is evaluated using MR phase images and is proven to be robust in the presence of noise. An application of the proposed method to the 3-point Dixon technique for water and fat separation is demonstrated.

Abstract

To evaluate a magnetic resonance (MR) imaging method that allows for simultaneous resolution of both the cardiac and respiratory cycles.Conventional and phase-contrast cine sequences were modified to provide additional resolution of the respiratory cycle. Data were collected in 11 healthy volunteers during MR imaging of the heart and portal vein. The imaging time was increased over that of a conventional cine acquisition by a factor equal to the number of frames in the respiratory cycle. Data were compared with those from comparable sequences in which only one motion cycle was resolved.In the heart, motion due to cardiac dynamics was separated from respiration-induced excursions. The extent of motion could be measured, and artifacts were minimized. Changes in flow rate as a function of both motion cycles were resolved and quantified in both the portal vein and superior vena cava.This method allows for simultaneous resolution of cardiac and respiratory motion cycles and helps provide a more physiologic view of the effects of cardiac and respiratory variations.

Abstract

We describe a technique to increase the velocity-to-noise ratio (VNR) of phase-contrast magnetic-resonance velocity images based on making three measurements/flow encoding axis rather than the usual two. A phase-aliased high first moment data set and a nonaliased low first moment data set are acquired, and the high-moment data are phase unwrapped using the low-moment data. The VNR of the resulting measurement is given by that of the high-moment measurement and increases linearly with the first moment. A factor of 4 gain in VNR was observed with only a 50% increase in scan time. Thus, this method is a much more efficient way to increase VNR than simple averaging.

Abstract

The accuracy of myocardial motion measurements, computed from cine-phase contrast (cine-PC) magnetic resonance (MR) velocity data, was compared with directly visualized motion of MR signal voids caused by implanted tantalum markers in anesthetized dogs.Magnetic resonance imaging (MRI) data were electrocardiogram-gated and divided into 16 phases per cardiac cycle. Myocardial trajectories as a function of time in the cardiac cycle were measured using both methods for four to seven markers in each of eight animals.The peak observed in-plane excursion was 4.0 +/- 2.1 mm. The average deviation between displacements derived from velocity data versus displacements visualized directly was 1.1 +/- 0.7 mm (27.5% of the peak displacement). The difference was less if three separate MR scans were used to measure each velocity component in the cine-PC method. This improvement is probably caused by improved temporal resolution.Cine-PC MRI offers a noninvasive method for accurate quantification of myocardial motion.

Abstract

The purpose of our study was to establish magnetic resonance imaging (MRI) criteria for the diagnosis of pulmonary vascular malformations (PVMs).Since 1987, 11 patients have been referred for chest MRI at our institution because of findings suggestive of a PVM. They were evaluated with a 1.5-T MRI system, incorporating a combination of spin-echo, gradient-recalled echo (GRE) cine, and 2-D phase contrast (PC) cine sequences. We used the following MRI criteria to diagnose PVM: (1) flow void or intermediate gray signal on spine-echo sequences; (2) bright signal on GRE cine sequences; and (3) bright signal consistent with flow detected on PC cine sequences using relatively low velocity ranges. Twelve patients not suspected of having a PVM served as controls; all had both MRI and pulmonary angiography to evaluate for central pulmonary embolus.Eight patients in the study group had PVM as determined with MRI using these criteria. In four of these patients, a PVM was confirmed by subsequent pulmonary angiography. Three patients did not have PVM utilizing these criteria; two had neoplasms and one had presumed mucus plugging and/or atelectasis that resolved spontaneously. The smallest vascular malformation detected by MRI was 1 cm. None of the control patients had PVM by MRI or pulmonary angiography.Utilizing these criteria, we believe that MRI is potentially an excellent noninvasive modality to evaluate PVM, and we stress that some form of PC cine sequence must be performed to determine if indeed there is blood flow within a suspicious lesion.

Abstract

Velocity gradient data from phase-contrast magnetic resonance (MR) imaging were tested for the ability to calculate tensile strain and shear strain (deformation) during cyclical motion of skeletal muscle.Strain data were derived from in vitro and in vivo phase-contrast MR velocity maps. A motion phantom designed to cyclically compress and expand a specimen of skeletal muscle provided a standard of reference to validate deformation, translation, and rotation measurements. The authors studied anterior and posterior muscle compartments of the lower extremity in three healthy volunteers during ankle dorsiflexion and plantar flexion against various resistances and the forearms of five healthy volunteers during flexion and extension of the fingers.The mean in vitro tracking error was 0.5 mm. The gastrocnemius muscle area in vivo changed 20% for both the minimum and maximum force conditions and therefore did not appear to be a good predictor of force.Phase-contrast MR imaging provides quantitative data on muscle contraction and demonstrates that shear and tensile strain can be measured and separated from translation and rotation of muscle.

Abstract

Phase-contrast magnetic resonance velocity-encoding techniques were used to track two-dimensional movement of skeletal muscle tissue. Axial and longitudinal planes in the forearms of five healthy volunteers were imaged during cyclic flexion and extension of the fingers, and the resulting data were used to plot the trajectories of the motion of pieces of muscle tissue. A phantom that produced complex two-dimensional trajectories validated the accuracy of the imaging and analysis techniques; after adjustments for phase errors, two-dimensional trajectories were tracked with an root-mean-square error of 0.1 cm. Preliminary results indicate that velocity-encoded image data can characterize motion trajectories and that refinements in data acquisition and analysis techniques may make it possible to correlate the movements of different regions within a muscle, characterize muscle contraction, and quantify longitudinal strain. This ability to track velocity vectors may provide a foundation for quantitative analysis of muscle motion.

Abstract

Time-resolved velocity imaging using the magnetic resonance phase contrast technique can provide clinically important quantitative flow measurements in vivo but suffers from long scan times when based on conventional spin-warp sequences. This can be particularly problematic when imaging regions of the abdomen and thorax because of respiratory motion. We present a rapid phase contrast sequence based on an interleaved spiral k-space data acquisition that permits time-resolved, three-direction velocity imaging within a breath-hold. Results of steady and pulsatile flow phantom experiments are presented, which indicate excellent agreement between our technique and through plane flow measurements made with an in-line ultrasound probe. Also shown are results of normal volunteer studies of the carotids, renal arteries, and heart.

Abstract

We present a reconstruction method for phased array multicoil data that is compatible with phase contrast MR angiography. The proposed algorithm can produce either complex difference or phase difference angiograms. Directional flow and quantitative information are preserved with the phase difference reconstruction. The proposed method is computationally efficient and avoids intercoil cancellation errors near the velocity aliasing boundary. Feasibility of the method is demonstrated on human scans.

Abstract

Time-of-flight and phase shift methods have both been used for vascular imaging with magnetic resonance. Phase methods, and phase contrast in particular, are well suited to quantitative measurements of velocity and volume flow rate. The most robust methods for measuring flow encode through-plane velocity into phase shift and compute flow by integrating the measured velocity over the vessel lumen. The accuracy of the flow data can be degraded by the effects of acceleration and eddy currents and by partial volume effects, including the effects of finite slice thickness and resolution, pulsatile waveforms, motion, and chemical shift. The reproducibility depends on the signal-to-noise of the data and the strength of the flow encoding and can be degraded by inconsistent definition of the vessel boundary. The adjustable flow sensitivity inherent in this method is a particular asset, allowing phase contrast flow measurement to operate over a dynamic range exceeding 10(5). Recently developed rapid imaging methods are helpful in applications that would be compromised by respiratory motion. With care, excellent quantitative data can be quickly obtained in vivo, and the resulting flow information is valuable for the diagnosis and management of a variety of conditions.

Abstract

After the occlusion of an internal carotid artery the principal source of collateral flow is through the arteries of the circle of Willis, but the size and patency of these arteries are quite variable. Study of the anatomy of the collateral pathways in patients with internal-carotid-artery occlusion with or without infarction in the watershed area of the deep white matter may identify patterns that afford protection from ischemic infarction.Using conventional magnetic resonance imaging and three-dimensional phase-contrast magnetic resonance angiography, we evaluated 29 consecutive patients (32 hemispheres at risk) with angiographically proved occlusion of the internal carotid artery. Four collateral pathways to the occluded vessel were evaluated: the proximal segment of the anterior cerebral artery, the posterior communicating artery, the ophthalmic artery, and leptomeningeal collateral vessels from the posterior cerebral artery.Only features of the ipsilateral posterior communicating artery were related to the risk of watershed infarction. The presence of posterior communicating arteries measuring at least 1 mm in diameter was associated with the absence of watershed infarction (13 hemispheres, no infarcts; P < 0.001). Conversely, there were 4 watershed infarcts in the 6 hemispheres with posterior communicating arteries measuring less than 1 mm in diameter and 10 infarcts in the 13 hemispheres with no detectable flow in the ipsilateral posterior communicating artery.A small (< 1 mm in diameter) or absent ipsilateral posterior communicating artery is a risk factor for ischemic cerebral infarction in patients with internal-carotid-artery occlusion.

Abstract

To determine whether phase-contrast magnetic resonance (MR) imaging can be used to measure stretch in the myotendinous junction and tendon.Velocity-encoded cine MR images obtained during cyclic motion were used to measure strain in myotendinous tissue and indirectly in tendons in gastrocnemius muscle-tendon sutured to a motion phantom. Videotapes of the experiments were digitized and used as a standard of reference for validation of MR measurements. Strain, rotation, and translation of the myotendinous junction were calculated from the phase-contrast MR data and indirectly in the tendon.Strain as determined from the MR imaging experiments agreed with the measurements from the video reference, with linear correlation coefficients of .987 for tendon strain and .992 for strain in the myotendinous junction.Measurement of tendon and myotendinous stretch during movement may provide insight into tendon ability to store energy and a means of noninvasive measurement of muscle force.

Abstract

There is at present no noninvasive method that reliably measures blood flow in the poorly functioning renal allograft. The present study was designed to evaluate phase-contrast cine magnetic resonance imaging (PC-cine-MRI) for this purpose. We recruited for study 18 patients who had received kidney transplants 13-66 months earlier from closely related living donors. As judged by the glomerular filtration rate, which was elevated for a single kidney (76 +/- 4 ml/min 1.73 m2), allograft function was excellent, permitting the assumption of unimpaired renal extraction of paminohippuric acid (PAH). Allograft blood flow was determined consecutively on the same day, first by the standard PAH clearance technique and they by the product of the velocity of protons and renal vein cross-sectional area using PC-cine-MRI. MRI determinations could not be completed because of claustrophobia in two patients and failure to image the terminus of the allograft vein another two. Comparison of blood flow in the remaining 14 subjects revealed the two techniques to be strongly related (r = 0.91, P < 0.001). On the average, the renal blood flow rate was similar by each method; 732 +/- 62 by PAH clearance and 703 +/- 69 ml/min by PC-cine-MRI, but the agreement among individuals between the two methods was only modest, with a 95% confidence interval of agreement from -214 to +254 ml/min. We conclude that PC-cine-MRI provides a fairly accurate and noninvasive method for determining the rate of blood flow in the transplanted kidney. With further refinement it should permit the role of depressed blood flow in a variety of acute and chronic forms of human allograft dysfunction to be elucidated in humans for the first time.

Abstract

The ability to measure skeletal muscle motion with phase-contrast magnetic resonance (MR) imaging was tested with a motion phantom that simulated muscle activity. Quantitative analytic data on unidimensional, bidirectional skeletal muscle motion measured in vivo was obtained in four healthy volunteers. MR images of the subjects' forearms were obtained during flexion and extension of the fingers and of the anterior and posterior muscle compartments of the lower leg with various resistances to ankle dorsiflexion and plantar flexion. It was necessary to correct the data for the effects of eddy currents. In vitro evaluation of the technique was done by studying through-plane sinusoidal motion of solid objects. The largest error was underestimation of the peak excursion of 11.5 mm by 0.09 mm (the root mean square error for the cycle was 0.04 mm) In vivo experiments demonstrated the contraction of muscles in relation to each other. Data acquisition and analysis techniques must be refined, but measuring skeletal muscle motion with phase-contrast MR imaging should enhance the understanding of bioengineering fundamentals and muscular changes in disease and adaptation.

Abstract

A method for time-resolved imaging that provides a flexible trade-off between imaging time and temporal resolution is presented. It is based on a view order selection technique that automatically segments the acquired raw data into appropriate temporal frames. When used with cardiac monitoring and phase-contrast imaging, data similar to that obtained with a conventional gated phase-contrast sequence are acquired rapidly. For many applications, the temporal resolution can be reduced enough to permit imaging within a breath-hold interval, while still allowing accurate time-averaged flow quantitation. This is a general technique that can be implemented within a variety of pulse sequences and can resolve other motion cycles, including the respiratory cycle.

Abstract

To present a spin-echo phase-contrast (SEPC) magnetic resonance pulse sequence designed to measure the very slow flow in ventricular shunt tubing.A flow phantom constructed of shunt tubing and incorporating no valve or a high-, medium-, or low-pressure valve was connected to a flow pump. Flow rates were 0.05-1.00 mL/min (72-1,440 mL/d). Flow measurement was performed with the thin-section SEPC sequence.The flow rates measured with SEPC imaging correlated closely with the pump flow rate for the entire physiologic spectrum of shunt flow rates. This was true for all valves, resulting in overall R2s of .974 at 4 cm/sec and .980 at 2 cm/sec. Shunt flow was pulsatile with valves in place. There was a linear relationship between flow rate and the frequency of valve opening and closing.The SEPC technique is an accurate and noninvasive method of measuring shunt flow.

Abstract

To measure mean blood flow in individual cerebral arteries (carotid, basilar, anterior cerebral, middle cerebral, and posterior cerebral) using a cine phase contrast MR pulse sequence.Ten healthy volunteers (22 to 38 years of age) were studied. The cine phase-contrast section was positioned perpendicular to the vessel of interest using oblique scanning planes. This pulse sequence used a velocity encoding range of 60 to 250 cm/sec. From the velocity and area measurements on the cine images, mean blood flow was calculated in milliliters per minute and milliliters per cardiac cycle. In the same subjects, transcranial Doppler measurements of blood velocity in these same vessels were also obtained.There was no difference in blood flow in the paired cerebral arteries. Carotid arteries had mean blood flow in the range of 4.8 +/- 0.4 ml/cycle, the basilar artery 2.4 +/- 0.2 ml/cycle, the middle cerebral artery 1.8 +/- 0.2 ml/cycle, the distal anterior cerebral artery 0.6 +/- 0.1 ml/cycle, and the posterior cerebral artery 0.8 +/- 0.1 ml/cycle. Overall, there was poor correlation between MR-measured and transcranial Doppler-measured peak velocity.Although careful attention to technical detail is required, mean blood flow measurements in individual cerebral vessels is feasible using a cine phase-contrast MR pulse sequence.

Abstract

Normal blood flow and velocity in the superior sagittal sinus were measured in 30 patients. A fast two-dimensional ungated phase-contrast (PC) pulse sequence was compared with a peripherally gated cine PC technique for velocity and flow quantitation. The same imaging parameters were used for both methods. Measured values for mean velocity and flow obtained with the two methods were compared by using regression analysis and t testing. For blood flow, the correlation coefficient was .976. For velocity measurements, r was .950. Mean flow was 285 mL/min +/- 19 with the ungated PC method and 281 mL/min +/- 19 with the cine PC method. The mean velocities measured with the two methods were 12.94 cm/sec +/- 1.1 and 13.59 cm/sec +/- 1.1, respectively. There was no significant difference (paired t test) between the methods for mean flow or velocity data. This was true even though flow in the superior sagittal sinus is moderately pulsatile, as shown with the cine PC technique. The ungated PC method provided these data in 13 seconds versus 3.5 minutes for the cine PC method.

Abstract

To compare superior mesenteric artery (SMA) blood flow in healthy volunteers and patients with stenoses in the fasting state and after food intake by using phase-contrast (PC) cine magnetic resonance (MR) imaging.Ten healthy subjects, four asymptomatic patients (three with 50% stenosis, one with 70% stenosis), and one symptomatic patient (with 80% stenosis) were studied. All subjects were studied after fasting at least 8 hours and 15, 30, and 45 minutes after ingesting a standard meal.In healthy volunteers, SMA blood flow at all postprandial intervals increased significantly compared with that obtained after fasting (P < or = .0005). The percentage change in SMA blood flow 30 minutes after food intake provided the best distinction between the healthy subjects, the asymptomatic patients, and the symptomatic patient.Cine PC MR imaging is an effective, noninvasive technique for measuring SMA blood flow.

Abstract

To compare lesion enhancement after injection of gadopentetate dimeglumine on spin-echo and gradient-echo T1-weighted images.A total of 48 contrast-enhancing intracranial lesions were evaluated using a spin-echo and two gradient-echo T1-weighted pulse sequences. Percent contrast, contrast-to-noise, and signal-to-noise measurements were made on the spin-echo T1-weighted, three-dimensional gradient-echo, and multiplanar gradient-echo sequences.The measurements were somewhat different for the following categories of lesions: extraaxial, intraaxial with edema, and intraaxial without edema. The latter group provided the greatest diagnostic challenge: three of 19 such lesions 1 cm in size or smaller could not be identified on three-dimensional gradient-echo images, and one could not be identified on multi-planar gradient-echo images. The spin-echo T1-weighted sequence demonstrated significantly higher percent contrast (P < .05) and greater contrast to noise (P < .03) than either gradient-echo sequence for these small intraaxial lesions without edema. For extraaxial and intraaxial lesions with edema, percent C was similar for spin-echo T1-weighted and three-dimensional gradient-echo images, while contrast to noise was greater for spin-echo T1-weighted images. This reflected greater tissue noise with gradient-echo sequences.The T1-weighted spin-echo sequence was preferred for detecting the full spectrum of contrast-enhancing lesions of the central nervous system.

Abstract

This prospective study was designed to establish the temporal and quantitative relationship between blood flow and cerebrospinal fluid (CSF) flow using a phase-contrast cine MR pulse sequence.A cine phase-contrast MR pulse sequence using peripheral gating was used to measure CSF flow direction and velocity. Data were acquired continuously and interpolated into 16 images throughout the cardiac cycle.The timing of systolic CSF flow in the cervical subarachnoid space (SAS) correlated very closely to the brain arteriovenous blood flow difference during the cardiac cycle. This arteriovenous difference was a measure of brain expansion. Aqueduct CSF flow during the cardiac cycle differed from SAS flow in that systolic flow was delayed in comparison with systolic cervical SAS flow. The normal aqueductal oscillatory flow volume was 1.7 +/- .4 mL/min or 0.03 +/- 0.01 mL per cardiac cycle. This represented 14.5% +/- 3.1% of the total CSF flow and tissue displacement through the incisura which was 14.5 +/- 2.2 mL/min or 0.22 +/- 0.03 mL per cycle. CSF oscillatory flow volume in the cervical SAS was 39.0 +/- 4.0 mL/min or 0.65 +/- 0.08 mL per cycle.CSF flow can be measured. Results in healthy subjects show relatively low oscillatory flow through the aqueduct which is slightly out of phase (delayed) compared with SAS CSF flow.

Abstract

Cine phase-contrast (PC) magnetic resonance (MR) pulse sequences have been used to measure blood flow in a variety of vessels. Because the cine PC sequence is time-consuming, this prospective study was undertaken to compare it with an ungated PC technique for measuring average blood flow in individual cerebral arteries to potentially achieve substantial time savings. The following cerebral arteries were studied in 10 healthy volunteers: carotid, basilar, middle cerebral, anterior cerebral, and posterior cerebral. Imaging planes were placed perpendicular to the vessel of interest, and velocity encoding, ranging from 40 to 250 cm/sec, was matched to individual arteries. Good correlation between cine and ungated PC blood flow measurements was obtained for both high- and low-flow vessels, with an overall correlation coefficient of .978. The ungated PC sequence, because of its short imaging time, allows measurement of the blood volume flow rate in the circle of Willis in approximately 20 minutes, a clinically acceptable time.

Abstract

The authors have developed a method to reduce noise in three-dimensional (3D) phase-contrast magnetic resonance (MR) velocity measurements by exploiting the property that blood is incompressible and, therefore, the velocity field describing its flow must be divergence-free. The divergence-free condition is incorporated by a projection operation in Hilbert space. The velocity field obtained with 3D phase-contrast MR imaging is projected onto the space of divergence-free velocity fields. The reduction of noise is achieved because the projection operation eliminates the noise component that is not divergence-free. Signal-to-noise ratio (S/N) gains on the order of 15%-25% were observed. The immediate effect of this noise reduction manifests itself in higher-quality phase-contrast MR angiograms. Alternatively, the S/N gain can be traded for a reduction in imaging time and/or improved spatial resolution.

Abstract

In the postoperative patient with anginal symptoms, differentiation between bypass graft compromise and nonischemic causes has until now been accomplished only by means of x-ray angiography. A non-invasive test is clearly desirable. The authors used a cine phase-contrast (PC) magnetic resonance (MR) imaging technique to characterize blood flow in native and grafted internal mammary arteries (IMAs). Ten volunteers and 15 patients who had recently undergone IMA coronary artery bypass grafting were imaged. Cine PC MR imaging was performed in the transaxial plane at the level of the pulmonary artery bifurcation. Flow in both IMAs was quantified and expressed as a percentage of cardiac output measured in the ascending aorta. In the 15 patients, flow analysis was performed in both the native and grafted IMAs. In the volunteers, IMA blood flow ranged from 2.1% to 4.3% of cardiac output on the left (mean, 3.5%) and 2.1% to 5.1% (mean, 3.5%) on the right. There was considerable intersubject variability, with coefficients of variation of 10.7% for the left and 12.3% for the right IMA. Intrasubject variability was limited, with estimated common standard deviations of 0.45% of cardiac output (range, 0.2%-1.1%) for the left and 0.39% (range, 0.1%-0.6%) for the right IMA. Flow in grafted IMAs was identified in 13 of 15 patients. In one of two patients without demonstrable IMA graft flow, cardiac catheterization confirmed lack of flow. IMA graft flow varied from 28 to 164 mL/min (mean, 80.3 mL/min). This study shows the feasibility of using cine PC MR imaging as a quantitative method of evaluating blood flow in IMA coronary artery bypass grafts.

Abstract

The flip angle which maximizes contrast between materials with different T1 can be calculated from the root of a cubic expression. A simple closed form expression can be used if contrast is defined in a differential sense and results in only slight contrast loss even with large T1 differences.

Abstract

The purpose of this study was to optimize a new rapid-acquisition MR pulse sequence, called fast multiplanar spoiled gradient-recalled (FMPSPGR) imaging, for breath-hold imaging of the liver and to compare unenhanced and contrast-enhanced FMPSPGR with standard spin-echo imaging in detecting liver tumors.The pulse sequence was optimized at 1.5 T with a healthy volunteer. Various scanning parameters were evaluated, and liver-spleen signal difference/noise measurements were used to estimate lesion contrast-to-noise ratios. We examined 24 patients with hepatic masses using the optimized sequence with spin-echo T1-weighted and T2-weighted imaging as well as unenhanced and gadopentetate dimeglumine-enhanced FMPSPGR imaging. The contrast-to-noise ratio for the hepatic tumors was determined for each sequence. Three radiologists who did not know the biopsy or test results reviewed all images for lesion conspicuity, lesion tissue specificity, and overall image quality.A comparison of unenhanced FMPSPGR images with spin-echo T1-weighted images showed a 40% improvement in mean contrast-to-noise ratio and a 70% improvement in liver signal-to-noise ratio for the FMPSPGR images. A comparison of gadopentetate dimeglumine-enhanced FMPSPGR images with spin-echo T1- and T2-weighted images showed a superior contrast-to-noise ratio for the enhanced FMPSPGR images in 17 (68%) of 25 hepatic lesions, which included all hepatic cysts (n = 3) and all hepatomas (n = 6), and in six of 12 patients with other liver tumors. The results of contrast-to-noise ratio for four patients with hemangiomas were mixed. For the remaining eight lesions, the contrast-to-noise ratio for spin-echo T1- and T2-weighted images predominated in three and five cases, respectively. Contrast-enhanced FMPSPGR images revealed a 40% and 300% increase in contrast-to-noise ratio compared with T2- and T1-weighted images, respectively. All three radiologists preferred the contrast-enhanced FMPSPGR images for overall image quality. For lesion conspicuity and specificity, however, the three radiologists differed, with a preference for the FMPSPGR images in 52%, 80%, and 40% of cases for lesion conspicuity and in 68%, 40%, and 60% of cases for lesion specificity.FMPSPGR is a new, ultrafast MR sequence that provides T1-weighted images of the liver during suspended respiration. Contrast-to-noise ratio and liver signal-to-noise ratio are significantly improved over those on conventional spin-echo T1-weighted images. The combination of breath-hold FMPSPGR with gadopentetate dimeglumine is an excellent technique that can be used to rapidly evaluate the liver with superior overall image quality. Contrast-to-noise ratios are generally superior to T2-weighted spin-echo images, making this technique a useful adjunct to conventional spin-echo MR imaging.

Abstract

One promising approach to flow quantification uses the velocity-dependent phase change of moving protons. A velocity-encoding phase subtraction technique was used to measure the velocity and flow rate of fluid flow in a phantom and blood flow in volunteers.In a model, the authors measured constant flow velocities from 0.1 to 270.0 cm/second with an accuracy (95% confidence intervals) of +/- 12.5 cm/second. There was a linear relationship between the magnetic resonance imaging (MRI) measurement and the actual value (r2 = .99; P = .0001).Measuring mean pulsatile flow from 125 to 1,900 mL/minute, the accuracy of the MRI pulsatile flow measurements (95% confidence intervals) was +/- 70 mL/minute. There was a linear relationship between the MRI pulsatile flow measurement and the actual value (r2 = .99; P = .0001). In 10 normal volunteers, the authors tested the technique in vivo, quantitating flow rates in the pulmonary artery and the aorta. The average difference between the two measurements was 5%. In vivo carotid flow waveforms obtained with MRI agreed well with the shape of corresponding ultrasound Doppler waveforms.Velocity-encoding phase subtraction MRI bears potential clinical use for the evaluation of blood flow. Potential applications would be in the determination of arterial blood flow to parenchymal organs, the detection and quantification of intra- and extra-cardiac shunts, and the rapid determination of cardiac output and stroke volume.

Abstract

To determine the direction of blood flow in the circle of Willis using a 3-D phase contrast MR angiographic (MRA) technique with high spatial resolution.Fifty healthy subjects and 15 patients with occlusive disease were studied using 3-D phase contrast MRA.In the 50 normal subjects, 39 (78%) had detectable flow in one or both posterior communicating arteries. In 24 (48%) of these subjects, flow was detected in both posterior communicating arteries, whereas unilateral flow was detected in 15 (30%). In 36 (92%) of the 39 normal subjects, flow in the posterior communicating artery was from anterior to posterior with only 3 (8%) showing reverse flow from posterior to anterior. The A1 segment of both anterior cerebral arteries was identified in 100% of normal subjects with flow in the expected direction from carotid to the A2 segment. In patients with carotid occlusion, the pattern of flow in the circle of Willis was altered with reversed flow in the ipsilateral posterior communicating artery and sometimes in the ipsilateral A1 segment. An ipsilateral posterior communicating artery was present in 10 of 17 occluded carotid arteries, all showing reversed flow.3-D phase contrast MRA provides useful information about the hemodynamics of normal and abnormal blood flow in the circle of Willis.

Abstract

Quantitative measurements of arterial and venous blood flow were obtained with phase-contrast cine magnetic resonance (MR) imaging and compared with such measurements obtained by means of implanted ultrasound (US) blood flow probes in anesthetized dogs. The US flowmeter was enabled during a portion of each MR imaging sequence to allow virtually simultaneous data acquisition with the two techniques. MR imaging data were gated by means of electrocardiography and divided into 16 phases per cardiac cycle. The rates of portal venous blood flow measured with MR imaging and averaged across the cardiac cycle (710 mL/min +/- 230 [standard deviation]) correlated well with those measured with the flowmeter and averaged in like fashion (751 mL/min +/- 238) (r = .995, slope = 1.053). The correspondence in arterial blood flow was almost as good. No statistically significant difference existed between the paired measurements of blood flow obtained with MR imaging and the implanted probe. It is concluded that, as a noninvasive means of accurate quantification of blood flow, phase-contrast MR imaging may be especially useful in deep blood vessels in humans.

Abstract

Brain motion during the cardiac cycle was measured prospectively in 10 healthy volunteers by using a phase-contrast cine magnetic resonance (MR) pulse sequence. The major cerebral lobes, diencephalon, brain stem, cerebellum, cerebellar tonsils, and spinal cord were studied. The overall pattern of brain motion showed caudal motion of the central structures (diencephalon, brain stem, and cerebellar tonsils) shortly after carotid systole, with concurrent cephalic motion of the major cerebral lobes and posterior cerebellar hemisphere. Peak brain displacement was in the range of 0.1-0.5 mm for all the structures except the cerebellar tonsils, which had greater displacement (0.4 mm +/- 0.16 [mean +/- standard error of mean]). Caudal motion of the central structures did not occur simultaneously but progressed in a caudal-to-rostral and posterior-to-anterior sequence, being seen first in the cerebellar tonsils and then later in the diencephalon (hypothalamus). Caudal motion of the low brain stem and cerebellar tonsil was simultaneous with caudal motion of cerebrospinal fluid in the cervical subarachnoid space. Oscillatory flow in the aqueduct was delayed compared with brain stem motion.

Abstract

A method for minimizing field-echo delay in moment-nulled gradient-echo imaging is presented. Even though ramps are accounted for, the analysis yields simple closed-form solutions. The method is then generalized to the section-select waveform for three-dimensional volume imaging and to flow encoding for phase-contrast imaging. Three strategies for first-moment selection in phase-contrast imaging are discussed, including a new strategy that always yields the minimum echo delay. Trapezoidal and triangular gradient lobe shapes are analyzed.

Abstract

This study assesses the ability of a cardiac-gated phase-contrast magnetic resonance imaging (MRI) technique to measure renal blood flow (RBF) noninvasively in humans.In nine normal volunteers, total RBF in the renal arteries and in the left renal vein was estimated by MRI and correlated with RBF determined by the clearance of para-aminohippuric acid (CPAH) and the hematocrit level.Correlation of RBF estimated from left renal vein flow, with RBF by CPAH-hematocrit, yielded r = .86 (P less than .003). Repeated measurement of RBF by MRI demonstrated a high degree of reproducibility, with coefficients of variation ranging from 4.8% to 8.9%. However, the MRI measurements of arterial flow did not significantly correlate with the standard measurements.Reproducible noninvasive measurement of normal RBF is possible with the phase-contrast MRI technique used to measure renal venous blood flow.

Abstract

This study evaluated a phase-contrast cine magnetic resonance (MR) imaging technique capable of simultaneously allowing determination of velocity and volume flow rate (VFR) in both carotid arteries and the basilar artery. Forty patients were studied; 24 were neurologically normal, and 16 had intracerebral arteriovenous malformations (AVMs). In the normal group, mean basilar flow was significantly less than mean carotid flow. Mean velocity and VFR showed a significant decline with age in the basilar artery. Carotid artery flow and total cerebral blood flow did not decline with age. In the AVM patients, flow and velocity measurements were significantly elevated in all three arteries. Flow in the carotid artery ipsilateral to the AVM was significantly greater than flow in the contralateral carotid artery. VFR increased in all three arteries with increasing AVM volume. Four patients underwent partial embolization, and a corresponding decrease in flow was observed. Phase-contrast cine MR imaging provides rapid, simultaneous, noninvasive velocity and VFR measurement in the major intracranial arteries.

Abstract

Phase contrast cine magnetic resonance imaging (MRI) combines the flow-dependent contrast of phase contrast MRI with the ability of cardiac cine imaging to produce images throughout the cardiac cycle. Two pulse sequence types are used for sensitivity to flow in one direction, whereas four are needed for sensitivity in all directions. Several alternatives for synchronization of the data to the cardiac cycle exist. Retrospectively interpolated methods can image the entire cardiac cycle efficiently. Rapid interleaving of the various sequence types ensures immunity to motion misregistration. The technique produces images in which contrast is related to flow velocity as well as magnitude images such as those of conventional cine MRI. The data can be interpreted qualitatively to demonstrate the presence, magnitude, and direction of flow, and quantitatively to provide estimates of flow velocity, volume flow rate, and displaced volumes. Phase contrast cine MRI is helpful in the diagnosis of aortic dissections, in the study of flow distributions in large vessels such as pulmonary arteries, as well as in smaller vessels such as carotid and basilar arteries, and in the evaluation of complex anatomical variants. Future developments are expected to reduce imaging time and expand the quantitative applications.

Abstract

Three encoding strategies for the measurement of flow velocities in arbitrary directions with phase-contrast magnetic resonance imaging are presented; their noise and dynamic range performance are compared by means of theoretical analysis and computer simulation. A six-point measurement strategy is shown to be quite inefficient in terms of velocity variance per unit time. A simple four-point method exhibits equal dynamic range; its noise depends on flow direction but on average is equal to that of the six-point method. An alternate, balanced four-point method has noise that is direction independent and has, depending on implementation, possibly lower noise levels. Either four-point method is more efficient and is preferred over the six-point approach.

Abstract

A technique for the simultaneous acquisition of three-dimensional phase-contrast angiograms and stationary-tissue images is described. Hadamard multiplexed encoding of flow information permits image acquisition times that are a third shorter than those of previous phase-contrast methods. The encoding scheme described also enables differentiation of flow-induced phase shifts from phase shifts due to resonance offset conditions such as field inhomogeneities and chemical shift. Display strategies that combine this phase information with the flow image are described.

Abstract

The purpose of this study was to evaluate the usefulness of limited-flip-angle, phase-sensitive velocity imaging with gradient-recalled-echo (VIGRE) MR when combined with spin-echo MR in the diagnosis of dural sinus thrombosis. The VIGRE sequence consists of a rapid single-slice acquisition, 50/15/2 (TR/TE/excitations), and 30 degrees flip angle. At each slice position, a total of four images were reconstructed; these consisted of one magnitude image and three images sensitive to proton motion in each orthogonal direction. The flow direction and flow velocity (cm/sec) were obtained from each of the phase images, and results were correlated with data obtained from a phantom experiment. In normal controls, dural sinus velocities ranged from a mean of 9.9 to 14.4 cm/sec for the transverse and superior sagittal sinuses, respectively. Three patients with proved dural sinus occlusion were studied with spin-echo images at 1.5 T. Three-dimensional time-of-flight MR angiography was also performed in one patient. The presence of dural sinus occlusion was determined by the lack of flow void on the spin-echo images, the absence of phase shift on the VIGRE study, and the presence of retrograde flow on the phase image in the sinus proximal to the occluded segment. Time-of-flight angiography overestimated the extent of the thrombosis caused by spin saturation. Follow-up VIGRE studies detected the formation of collateral flow in one patient and recanalization with the establishment of normal antegrade sinus flow in the other. We conclude that phase-sensitive MR imaging is helpful in establishing the diagnosis and extent of dural sinus occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Abstract

A phase-contrast cine magnetic resonance (MR) imaging technique was used to study normal dynamics of cerebrospinal fluid (CSF) in 10 healthy volunteers and four patients with normal MR images. This pulse sequence yielded 16 quantitative flow-encoded images per cardiac cycle (peripheral gating). Flow encoding depicted craniocaudal flow as high signal intensity and caudo-cranial flow as low signal intensity. Sagittal and axial images of the head, cervical spine, and lumbar spine were obtained, and strategic sites were analyzed for quantitative CSF flow. The onset of CSF systole in the subarachnoid space was synchronous with the onset of systole in the carotid artery. CSF systole and diastole at the foramen of Monro and aqueduct were essentially simultaneous. The systolic and diastolic components were different in the subarachnoid space, where systole occupied approximately 40% and diastole 60% of the cardiac cycle, compared with the ventricular system, where they were equal. This difference results in systole in the intracranial and spinal subarachnoid spaces preceding that in the ventricular system; the same is true for diastole. The fourth ventricle and cisterna magna serve as mixing chambers. The high-velocity flow in the cervical spine and essentially no flow in the distal lumbar sac indicate that a portion of the capacitance necessary in this essentially closed system resides in the distal spinal canal.

Abstract

Detection of acute renal failure (ARF) using fast-scan magnetic resonance imaging (MRI) with Gd-DTPA was studied in a dog model. ARF was produced in five dogs by infusion of norepinephrine (0.75 micrograms/kg/min) into the renal arteries for 40 minutes. MRI was performed 1 hour later and compared with baseline (pre-ARF) MRI. There was no significant difference in the ratios of signal intensity-vs.-time curves from 0 to 35 seconds after injection of Gd-DTPA. However, a difference between the outer and inner medulla was significant in the time period of 5 to 20 minutes after Gd-DTPA injection. These later signal intensity differences by fast-scan (gradient-echo) technique may be useful in the evaluation of ARF.

Abstract

To assess blood flow rapidly, a limited-flip-angle, gradient recalled pulse sequence was modified to acquire two views at the same phase-encoding step in successive repetitions. One view is obtained with first-moment flow compensation, while the second view is obtained with selectable flow encoding (non-zero first moment) along one direction. Blood flowing along the encoded direction acquires a phase difference between the two views, resulting in signal dependent on both direction and speed of flow. Stationary tissues undergo no phase change. Therefore, the phase shift between the two views produces an image that spatially renders flow direction and velocity. With a 24-msec repetition time, a 256 X 128 matrix, and two excitations, data acquisition is completed in 13 seconds per location (both a magnitude image and a flow image are produced at each location). Images generated with flow phantoms confirmed the accuracy of this method. Preliminary clinical evidence in 23 human subjects suggests that this method is useful in evaluating portal hypertension, distinguishing arterial from venous flow, distinguishing between slow flow and clot, and confirming the presence of clot. This method appears to be a fast, easy way to assess blood flow in large vessels.

Abstract

Several aspects of blipped echo-planar imaging (EPI) are treated mathematically. An expression relating the necessary readout gradient strength and sampling time to the spatial resolution and readout duration is derived. It is shown how the net spatial resolution may be limited by the object's T2 characteristics and B0 field homogeneity, irrespective of the number of sampled points. Additionally, off-resonance effects result in a loss of spatial resolution and image distortion to a considerably greater degree than in conventional two-dimensional Fourier transform imaging. The extent of these effects is directly related to the time required to acquire the data matrix, and is therefore amplified when EPI is implemented on a standard commercial whole-body system which because of limited gradient performance uses necessarily longer sampling durations. Specific hardware modifications to a standard commercial imager are considered to allow successful EPI implementation. EPI image characteristics are compared quantitatively with those of conventional methods.

Abstract

A method of subtraction angiography that has an acquisition time of 8 s per slice is described. Flow-compensated and uncompensated measurements are acquired in an interleaved fashion using limited flip angles and gradient refocusing. Magnitude images are reconstructed and subtracted to generate the angiogram. Results were generated in vivo in the imaging of the carotid bifurcation of several human volunteers. Susceptibility and inhomogeneity induced artifacts are prominent in thick slices, but can be greatly reduced by imaging several thin slices and adding them together. Thin slices do not require dephasing gradients to reduce the dynamic range, and there is no signal cancellation in overlapping vessels. The method is ideal for acquiring scout angiograms, and with averaging may produce images of diagnostic quality.

Abstract

Cine magnetic resonance (MR) imaging is a new technique that combines short repetition times, limited flip angles, gradient refocused echoes, and cardiac gating. This technique has a temporal resolution of up to 32 time frames per cardiac cycle and accentuates signal from flowing blood. Cine MR images of 56 valves in 27 patients were evaluated and compared with either Doppler echocardiograms or cardiac catheterization images. An area of decreased signal that correlated spatially and temporally with regurgitant blood flow was seen in all instances in which valvular incompetence was demonstrated on either Doppler echocardiograms or cardiac catheterization images (20 valves). This abnormality was seen in nine of 36 cases without valvular incompetence. Cine MR imaging may be sensitive to turbulence and thus sensitive to valvular regurgitation.

Abstract

Cine MR imaging provides tomographic images of the heart with both high spatial and high temporal resolution. As many as 32 images per cardiac cycle can be acquired with up to four separate anatomic slices and a total imaging time of 128 cardiac cycles. End-diastolic and end-systolic volumes were determined in 11 patients, and ejection fractions were calculated. The results correlated linearly with those from cardiac catheterization (correlation coefficient of .88). We conclude that cine MR imaging can be used to obtain quantitative information about the heart and has the potential to become a valuable noninvasive means of cardiac evaluation.

Abstract

MR images can be obtained with a 2-sec scan time when an extremely short repetition rate (22 msec), limited flip angle (30 degrees), and gradient refocused echoes are used. Comparison of 415 such images obtained in 29 patients with routine T1-weighted (TR 500, TE 25) and T2-weighted (TR 2000, TE 80) images showed that images free of respiratory artifacts could be obtained in all patients. Although abdominal organs were well seen with 2-sec scan time, overall evaluation of these organs was better on routine T1-weighted images. Vascular structures, however, were seen as well or better on the 2-sec images in 60% of cases. The images were extremely sensitive to field nonhomogeneity, and metallic artifact was exaggerated in five patients with surgical clips. Two-sec MR images provide a rapid method of localizing abdominal organs for further evaluation. The sensitivity to blood flow may assist in the assessment of vascular patency.

Abstract

We present a method for rapid measurement of T1 relaxation times using gradient refocused images at limited flip angles and short repetition times. This "variable nutation" techniques was investigated using a T1 phantom. There was a high correlation between measurements obtained with the variable nutation and partial saturation techniques. The ability of this method to create calculated T1 images is also demonstrated. We conclude that the variable nutation method may allow measurement of T1 relaxation times with a significant reduction in acquisition time compared to partial saturation techniques.

Abstract

A method of chemical-shift imaging is described using the invariance of chemical shifts to changes in magnetic field gradients used for frequency encoding of position in imaging. This enables separation of the effects on the observed signal of chemical shift from the effects of different positions along the imaging gradient when the signal is observed with different gradients. A simple implementation for a two-line spectrum is presented using signals observed with normal and reversed imaging gradients. This is used to create "fat" and "water" images of the thigh.

Abstract

This paper is concerned with the characterization of attenuation in tissue. A simple method for measuring frequency dependent attenuation is demonstrated. The effects of frequency dependent scatter on the measurement of attenuation are also considered in order to determine the theoretical and practical ramifications of this interfering effect. Finally, a means of placing definitive error bounds on the statistical reliability of the measurement is discussed.

Abstract

Various means of characterizing ultrasonic attenuation in tissue are reviewed. A simple method for estimating frequency-dependent attenuation via measurement of the zero crossing density of the signal is presented and validated. Both the effects of the frequency dependence of scatter and stochastic variability of the measurement are considered and discussed. Results of measurements made in phantoms, animals and humans are presented and compared to the theoretical model. The technique is shown to be technically feasible.

Abstract

This new digital fluorography processing method of matched filtering generates a set of images that have been acquired at continuous video-frame rates (30 per second) over the temporal extent of the bolus (10 seconds), and it combines them to produce the equivalent of a single digital subtraction angiography (DSA) image. Because of the extensive temporal averaging used, the method can provide substantial x-ray exposure reduction per run as compared with conventional techniques for an equivalent signal-to-noise ratio in the final image. The matched filtering technique was compared with conventional pulsed (one per second) DSA images of both extracranial and intracranial arteries, and the results are presented. Matched filtered images provided image quality that was equivalent to that of conventional DSA images at about one-fourth the patient exposure per run for both carotid artery and cerebral vessel studies. Despite long integration times, patient motion irretrievably corrupted image quality in only two of five carotid artery studies and in none of three intracranial studies. Compensation for patient motion is demonstrated, and additional applications and limitations of the technique are discussed.

Abstract

The technical characteristics of a new digital fluorographic image processing method called matched filtering are presented. This technique, a type of extensive temporal integration, takes a weighted sum of images acquired during passage of a contrast bolus through some area of interest. The weight of each image is governed by the magnitude of the contrast bolus in that image. An essential requirement of the matched filter is that its integral be zero. It is shown for equal exposure rates and typical bolus characteristics that matched filtering provides a factor of two higher signal-to-noise ratio (SNR) than conventional methods for bolus transit times of 10 s or higher. Equilvalently, matched filtering can yield images with quality comparable to conventional digital subtraction angiography (DSA) at a factor of four less patient exposure. The SNR obtained with matched filtering is shown to be within 30% of an ideal bound. Comparisons of matched filtering to standard recursive methods and simple integration are made. Experimental canine studies are presented which compare matched filtering with conventional DSA.

Abstract

Intravenous digital subtraction angiography (iDSA) promises to significantly alter the use of conventional cerebral angiography in the workup of neurological patients. Understanding its diagnostic potential and its limitations are important in incorporating this new examination into the diagnostic thought process of neuroradiologic tests. Different image processing techniques such as integration of mask and contrast images promise to improve image quality for neuroradiologic application. At present, iDSA is suitable for the diagnosis and follow-up of vascular lesions (atherosclerosis, aneurysms, arteriovenous malformations, venous sinus occlusion), and tumor (meningioma). Although limited, the spatial resolution of iDSA studies is capable of demonstrating diffuse vascular disease such as arteritis and vasospasm after subarachnoid hemorrhage. In some patients in conjunction with the CT scan, iDSA may prove sufficient as the primary and only diagnostic angiographic test necessary, supplanting conventional angiography.

Abstract

The application of digital computers to electronic x-ray imaging devices has rejuvenated interest in the field of intravenous arteriography. By utilizing computer image subtraction techniques, digital roentgenographic systems based on fluoroscopy or computed tomography (scanned projection radiography) provide significantly improved vascular imaging compared with conventional film subtraction methods. Digital subtraction angiography schemes isolate contrast media in the vessel by detecting differences in images obtained before and after the injection of contrast medium or changes in the relative attenuation of contrast media at different x-ray energies. Present applications include carotid and peripheral arteriography, thoracic and abdominal aortography, pulmonary arteriography, and ventriculography. Future applications may include intracerebral and coronary arteriography. These systems should provide low-risk outpatient screening arteriography.

Abstract

Implanted surgical metal clips often produce objectionable artifacts in CT reconstructions. The artifacts appear as streaks which emanate radially from the site of the clip. It is shown in this paper that these artifacts stem primarily from motion of the clip during the scan. An algorithm is described which reduces the intensity of these artifacts. The procedure attempts to remove the metal object entirely from the scan data by replacing the measured projection values of rays that passed through a neighborhood of the clip with calculated values consistent with an object whose density is an average of the surround. Examples are given for head and body scans as well as for computer simulations which show substantial reduction of the streak intensity.

Abstract

Visualization of arteries using intravenous injections of contrast material requires an imaging system capable of (a) excellent sensitivity to dilute concentrations of contrast media and (b) adequate temporal resolution to minimize the effects of motion during the exposure. A line-scanned radiography system based on a CT fan-beam detector (high-pressure xenon ionization chamber) was used for phantom and animal studies of intravenous arteriography to demonstrate the potential advantages of this method. Even though line-scanned systems require long scan times compared to existing radiographic methods, they are capable of showing rapidly moving arteries without blurring. Concentrations of 3 mg/ml of iodine could be seen in vessels 2 mm in diameter. Phantom studies using kVp switching showed that bone or soft tissue could be selectively cancelled.

Abstract

Dual energy basis decomposition techniques apply to single projection radiographic imaging. The high and low energy images are non-linearly transformed to generate two energy-independent images characterizing the integrated Compton/photoelectric attenuation components. Characteristic linear combinations of these two basis images identify unknown materials, cancel known materials, and generate synthesized monoenergetic images. The problems of intervening materials and material displacement are solved in general for a wide class of clinical imaging tasks. The basis projection angle identifies one from a family of energy selective imaging tasks, and such performance measures as the contrast enhancement factor (CEF) and signal to noise ratio (SNR) are expressed as functions of this angle. Algorithms for the decomposition of high and low energy measurements are compared and experimental images are included.

Abstract

Digital subtraction and an experimental system for line-scanned radiography were used to image the bifurcations of the carotid arteries. The subtracted images were obtained before and after injections of contrast media. The anatomy of the extracranial carotid arteries was demonstrated in most patients, and verified by selective catheter arteriograms. Unsuccessful studies were attributed to improper timing while obtaining the images, and to venous occlusion. Artifacts produced by motion limit the temporal subtraction method.

Abstract

Dark streaks connecting the petrous bones are often observed in cranial transverse section CT reconstructions. These artifacts are usually only slightly diminished by two-pass beam hardening corrections. However, it is found that by narrowing the slice thickness the artifacts are substantially reduced. In this paper, it is shown that axial partial volume effects can account for the presence of the artifacts. These axial partial volume effects occur when, at any point in the slice, the object has axial variations in attenuation. In such cases the logarithm of the integrated intensity measured by the detector is not a linear function of the integrated attenuation (even for monochromatic beams). This nonlinearity causes inconsistencies in the data set which in turn can cause streaks in the image. We have studied the partial volume effect using computer simulation. Algorithms are presented whose purpose is to correct for these effects by estimating the axial variation using neighboring slices. These correction algorithms are successful in computer simulation cases but failed with clinical data. It is concluded that no practical correction method is viable unless overlap scanning is employed. However, thin-slice scanning for sections where these artifacts are common is perhaps a more preferable solution.

Abstract

Present popular computed tomography (CT) algorithms reconstruct an object from the ray measurements lying on a set of parallel planes. This paper presents an algorithm that can also utilize "cross-plane" rays (i.e., rays that cross through many planes) to reconstruct the object. In this reconstruction algorithm, the ray measurements are grouped into two-dimensional projections, filtered, and stored. The filtered projections can then be back-projected onto a three-dimensional matrix or any plane through the three-dimensional volume. General theoretical aspects are presented and then applied to the special case in which ray measurements have been made in all directions. The algorithm is tested using computer-generated data. Expressions for the noise power spectrum and the variance in the reconstruction are derived. It is shown that the noise-to-signal ratio per detected photon for this reconstruction method is close to a theoretical limit, as it also is for normal CT. The ability to use ray measurements that cross many planes is especially useful in emission CT, where order-of-magnitude improvements in image quality per unit dose can be achieved.

Abstract

An expression is derived showing that the two-dimensional noise power spectrum of computed X-ray tomography is proportional to [G(k)]2/k where k is the radial spatial frequency and G(k) is the one-dimensional corrective filter used in the filtered back-projection reconstuction technique. It is shown that predicted noise power spectra compare well with those estimated from CT reconstructions of simulated noise for both the ramp filter and the Hanning-weighted ramp filter. A consequence of the non-uniform shape of the noise power spectrum is that statistical noise in CT reconstructions is correlated from point to point. Because of this correlation when the reconstructed CT values are averaged over some region, the uncertainty of the average depends on the shape of the region as well as its area. This dependence is confirmed by computer simulations.

Abstract

A general expression is derived for the noise due to photon counting statistics in computed X-ray tomography. The variance is inversely proportional to the cube of the resolution distance. For scanners using a water box, the noise in the reconstructed image depends inversely on the number of detected primary photons, summed over all angles, that have passed through a resolution element. Predictions of this formula agree well with the results of computer simulations. It is shown how this formula can be used to determine such parameters as required X-ray flux, detector counting rate, and dose, with special emphasis on tradeoffs between these parameters and resolution. It is also shown that to determine the X-ray attenuation coefficient of a resolution element to a given precision, the number of photons required by computed X-ray tomography is close to a theoretical limit.